Doctor Name: | SUSAN F BAKER |
NPI Number: | 1356384317 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CNP |
License Number: | R025934 |
Business Practice Address: | Ihs Main Street Eagle Butte, SD - 576251012 |
Business Phone Number: | 6059643004 |
Business Fax Number: | 6059641110 |
Mailing Address: | Po Box 1145, EAGLE BUTTE |
State: | SD |
Postal Code: | 576251145 |
Phone Number: | 6059648521 |
Fax Number: | |
NPI Enumeration Date: | 06/14/2006 |
NPI Last Update Date: | 11/07/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | R025934 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SD |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |