Provider Demographics
NPI:1063634236
Name:BAKER, MARGARET ELAINE (R N)
Entity Type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:ELAINE
Last Name:BAKER
Suffix:
Gender:F
Credentials:R N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70100 MIRAGE COVE DR
Mailing Address - Street 2:UNIT # 16
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270-2968
Mailing Address - Country:US
Mailing Address - Phone:760-324-0918
Mailing Address - Fax:
Practice Address - Street 1:70100 MIRAGE COVE DR
Practice Address - Street 2:UNIT # 16
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-2968
Practice Address - Country:US
Practice Address - Phone:760-324-0918
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA479120163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAEPSO13060OtherPROVIDER NUMBER
CARVN001560OtherPROVIDER NUMBER