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NPI Code Detail

MEDICARE: ANDRIA WINONA BAKER LPN

MEDICARE: ANDRIA WINONA BAKER LPN
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
1164W00000XLicensed Practical NursePN137810OH

General Provider Information

NPI Number : 1952677403
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDRIA WINONA BAKER LPN
Provider Business Mailing Address
First Line : 11423 RAPHAEL PL
Second Line :
City : CINCINNATI
State : OH
Zip : 45240-2013
Country : US
Telephone Number : 513-328-1954
Fax Number :
Provider Business Practice Location Address
First Line : 11423 RAPHAEL PL
Second Line :
City : CINCINNATI
State : OH
Zip : 45240-2013
Country : US
Telephone Number : 513-328-1954
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/29/2012
Last Update Date : 03/29/2012

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Directions to “ ANDRIA WINONA BAKER LPN” Practice Location

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