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NPI Code Detail

MEDICARE: IVEE NIKOLE BAKER

MEDICARE: IVEE NIKOLE BAKER
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1588371041
Entity Type Code : Individual
Provider Name (Legal Business Name) : IVEE NIKOLE BAKER
Provider Business Mailing Address
First Line : 2405 PALMER CIR STE 100
Second Line :
City : NORMAN
State : OK
Zip : 73069-6351
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4515 E 91ST ST
Second Line :
City : TULSA
State : OK
Zip : 74137-2861
Country : US
Telephone Number : 918-730-9123
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2022
Last Update Date : 11/03/2022

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Directions to “ IVEE NIKOLE BAKER ” Practice Location

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