MEDICARE: KENNETH BAKER

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	172A00000X	Driver
2	3747P1801X	Personal Care Attendant
3	376J00000X	Homemaker

General Provider Information

NPI Number	:	1922819937
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENNETH BAKER

Provider Business Mailing Address
First Line	:	2245 MEADOWBROOK DR
Second Line	:
City	:	SPRINGFIELD
State	:	OH
Zip	:	45506-3214
Country	:	US
Telephone Number	:	937-450-7671
Fax Number	:

Provider Business Practice Location Address
First Line	:	2245 MEADOWBROOK DR
Second Line	:
City	:	SPRINGFIELD
State	:	OH
Zip	:	45506-3214
Country	:	US
Telephone Number	:	937-450-7671
Fax Number	:

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

Provider Enumeration Date	:	01/17/2025
Last Update Date	:	01/17/2025

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Directions to “ KENNETH BAKER ” Practice Location

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