MEDICARE: WENDY K BAKER FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0200X	Pediatric Nurse Practitioner	1902	SC
2	363L00000X	Nurse Practitioner	1902	SC

General Provider Information

NPI Number	:	1528014727
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WENDY K BAKER FNP

Provider Business Mailing Address
First Line	:	PO BOX 19305
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28219-9305
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1656 RIVERCHASE BLVD
Second Line	:	STE 3400
City	:	ROCK HILL
State	:	SC
Zip	:	29732-2084
Country	:	US
Telephone Number	:	803-328-6281
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/26/2006
Last Update Date	:	06/06/2025

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