Provider Demographics
NPI:1215188412
Name:BAKER, JAMIE VENEETA (APRN)
Entity Type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:VENEETA
Last Name:BAKER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1077 RAINTREE LN
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-5242
Mailing Address - Country:US
Mailing Address - Phone:479-957-7132
Mailing Address - Fax:
Practice Address - Street 1:1077 RAINTREE LN
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-5242
Practice Address - Country:US
Practice Address - Phone:479-957-7132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-06
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR097863163W00000X
ARA004302363LF0000X
FLAPRN11005989363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL004480200Medicaid
FL004480200Medicaid