Provider Demographics
NPI:1346661402
Name:BAKER, CAGNEY (RN-BSN)
Entity Type:Individual
Prefix:MRS
First Name:CAGNEY
Middle Name:
Last Name:BAKER
Suffix:
Gender:F
Credentials:RN-BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:470 HULON LANE
Mailing Address - Street 2:ATTN: VP OF REVENUE CYCLE
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29169-4810
Mailing Address - Country:US
Mailing Address - Phone:803-791-2000
Mailing Address - Fax:
Practice Address - Street 1:338 E COLUMBIA AVE
Practice Address - Street 2:
Practice Address - City:BATESBURG LEESVILLE
Practice Address - State:SC
Practice Address - Zip Code:29070-9285
Practice Address - Country:US
Practice Address - Phone:803-604-0066
Practice Address - Fax:803-604-9924
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-17
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC205622163WS0200X
SC24193363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WS0200XNursing Service ProvidersRegistered NurseSchool