Provider Demographics
NPI:1295600336
Name:BAKER, JENEL JUNE
Entity type:Individual
Prefix:
First Name:JENEL
Middle Name:JUNE
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 1:59050 879 RD
Mailing Address - Street 2:
Mailing Address - City:PONCA
Mailing Address - State:NE
Mailing Address - Zip Code:68770-7073
Mailing Address - Country:US
Mailing Address - Phone:712-251-7523
Mailing Address - Fax:402-755-2387
Practice Address - Street 1:117 N UNION ST STE 1
Practice Address - Street 2:
Practice Address - City:PONCA
Practice Address - State:NE
Practice Address - Zip Code:68770-7297
Practice Address - Country:US
Practice Address - Phone:712-251-7523
Practice Address - Fax:402-755-2387
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-08
Last Update Date:2025-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider