Provider Demographics
NPI:1437752276
Name:BAKER, JENNIFER ANN (PHARMD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ANN
Last Name:BAKER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 99
Mailing Address - Street 2:
Mailing Address - City:GRETNA
Mailing Address - State:NE
Mailing Address - Zip Code:68028-0099
Mailing Address - Country:US
Mailing Address - Phone:402-332-5990
Mailing Address - Fax:402-332-0266
Practice Address - Street 1:611 N HIGHWAY 6
Practice Address - Street 2:
Practice Address - City:GRETNA
Practice Address - State:NE
Practice Address - Zip Code:68028
Practice Address - Country:US
Practice Address - Phone:402-332-5990
Practice Address - Fax:402-332-0266
Is Sole Proprietor?:No
Enumeration Date:2020-11-16
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE123221835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist