Provider Demographics
NPI:1346521325
Name:BAKER, NETRA G (RN)
Entity Type:Individual
Prefix:
First Name:NETRA
Middle Name:G
Last Name:BAKER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:COUDERSPORT
Mailing Address - State:PA
Mailing Address - Zip Code:16915-1630
Mailing Address - Country:US
Mailing Address - Phone:814-274-8651
Mailing Address - Fax:814-274-8652
Practice Address - Street 1:110 LINCOLN ST
Practice Address - Street 2:
Practice Address - City:RIDGWAY
Practice Address - State:PA
Practice Address - Zip Code:15853-1939
Practice Address - Country:US
Practice Address - Phone:814-776-2145
Practice Address - Fax:814-776-1470
Is Sole Proprietor?:No
Enumeration Date:2011-09-02
Last Update Date:2011-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN263414L163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse