Provider Demographics
NPI:1275280364
Name:BAKER, BAILEY GRACE (APN)
Entity Type:Individual
Prefix:
First Name:BAILEY
Middle Name:GRACE
Last Name:BAKER
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:463 1ST ST NW
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37311-1760
Mailing Address - Country:US
Mailing Address - Phone:423-790-7662
Mailing Address - Fax:423-790-7664
Practice Address - Street 1:463 1ST ST NW
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37311-1760
Practice Address - Country:US
Practice Address - Phone:423-790-7662
Practice Address - Fax:423-790-7664
Is Sole Proprietor?:No
Enumeration Date:2022-03-08
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN30911363LF0000X, 363LP0808X
TNAPN0000030911363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care