Provider Demographics
NPI:1326376906
Name:BAKER, ELIZABETH FAITH (PA-C)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:FAITH
Last Name:BAKER
Suffix:
Gender:F
Credentials:PA-C
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:7104 GLOUCHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-4112
Mailing Address - Country:US
Mailing Address - Phone:612-708-2683
Mailing Address - Fax:
Practice Address - Street 1:2600 39TH AVE NE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55421-4379
Practice Address - Country:US
Practice Address - Phone:763-581-5500
Practice Address - Fax:763-581-5501
Is Sole Proprietor?:No
Enumeration Date:2009-11-19
Last Update Date:2013-02-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN10635363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant