Provider Demographics
NPI:1114143153
Name:BAKER, ALMARIA (MED-IECE)
Entity Type:Individual
Prefix:
First Name:ALMARIA
Middle Name:
Last Name:BAKER
Suffix:
Gender:F
Credentials:MED-IECE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3643 NICHOLS MEADOW CIRCLE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40215
Mailing Address - Country:US
Mailing Address - Phone:502-363-1580
Mailing Address - Fax:
Practice Address - Street 1:4910 SIMPSON DRIVE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40218
Practice Address - Country:US
Practice Address - Phone:502-459-6344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY01367OtherDEVELOPMENT INTERVENTIONI