Provider Demographics
NPI:1093271496
Name:BAKER, SHEMICA NICOLE (NP)
Entity Type:Individual
Prefix:
First Name:SHEMICA
Middle Name:NICOLE
Last Name:BAKER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:SHEMICA
Other - Middle Name:NICOLE
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:517 CHELTENHAM DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-2534
Mailing Address - Country:US
Mailing Address - Phone:252-468-4606
Mailing Address - Fax:
Practice Address - Street 1:701 DOCTORS DR STE E2
Practice Address - Street 2:
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28501-1584
Practice Address - Country:US
Practice Address - Phone:252-775-5940
Practice Address - Fax:252-208-1177
Is Sole Proprietor?:No
Enumeration Date:2019-02-11
Last Update Date:2021-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC255263363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily