Doctor Name: | JULIA BAKER |
NPI Number: | 1063887958 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APRN |
License Number: | A004564 |
Business Practice Address: | 3519 Highway 63 Black Rock, AR - 724159022 |
Business Phone Number: | 8708784005 |
Business Fax Number: | 8709947488 |
Mailing Address: | 49 Highway 62 412, ASH FLAT |
State: | AR |
Postal Code: | 725139594 |
Phone Number: | 8709947301 |
Fax Number: | 8709947488 |
NPI Enumeration Date: | 12/03/2015 |
NPI Last Update Date: | 12/03/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | A004564 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AR |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |