Provider Demographics
NPI:1043551716
Name:BAKER, NATALIE R (CRNP)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:R
Last Name:BAKER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12205 COUNTY LINE RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-7719
Mailing Address - Country:US
Mailing Address - Phone:256-325-4365
Mailing Address - Fax:256-461-0393
Practice Address - Street 1:12205 COUNTY LINE RD
Practice Address - Street 2:SUITE B
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-7719
Practice Address - Country:US
Practice Address - Phone:256-325-4365
Practice Address - Fax:256-461-0393
Is Sole Proprietor?:No
Enumeration Date:2013-03-06
Last Update Date:2013-03-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL147392-21363LA2200X
AL0190343-23364SG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No364SG0600XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistGerontology