Provider Demographics
NPI:1073202867
Name:BAKER, DENISE N
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:N
Last Name:BAKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3016 S EDSEL ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48217-2401
Mailing Address - Country:US
Mailing Address - Phone:313-283-5362
Mailing Address - Fax:
Practice Address - Street 1:3016 S EDSEL ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48217-2401
Practice Address - Country:US
Practice Address - Phone:313-283-5362
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-05
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health