MEDICARE: MARIE DAWN BAKER APRN

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	207Q00000X	Family Medicine Physician	1137736	KY
2	363LF0000X	Family Nurse Practitioner	3014098	KY
3	207Q00000X	Family Medicine Physician	1134736	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1134736	OTHER	KY	KBN
2	F11190478	OTHER		AANP
3	3014098	OTHER	KY	KBN
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1659917524
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIE DAWN BAKER APRN

Provider Business Mailing Address
First Line	:	321C E COLLEGE AVE
Second Line	:
City	:	STANTON
State	:	KY
Zip	:	40380-2325
Country	:	US
Telephone Number	:	606-663-9797
Fax Number	:	606-663-9470

Provider Business Practice Location Address
First Line	:	321C E COLLEGE AVE
Second Line	:
City	:	STANTON
State	:	KY
Zip	:	40380-2325
Country	:	US
Telephone Number	:	606-663-9797
Fax Number	:	606-663-9470

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

Provider Enumeration Date	:	11/26/2019
Last Update Date	:	03/22/2021

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Directions to “ MARIE DAWN BAKER APRN” Practice Location

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