Provider Demographics
NPI:1376253195
Name:BAKER, BRIANNA JEAN (BSN, RN, CCRN)
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:JEAN
Last Name:BAKER
Suffix:
Gender:F
Credentials:BSN, RN, CCRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6251 NOTTINGHAM AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63109-3162
Mailing Address - Country:US
Mailing Address - Phone:618-979-1538
Mailing Address - Fax:
Practice Address - Street 1:4483 DUNCAN AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1111
Practice Address - Country:US
Practice Address - Phone:314-454-7055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-02
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2019004162163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine