Provider Demographics
NPI:1457320368
Name:BAKER, ANNA CHAMPION (CRNA)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:CHAMPION
Last Name:BAKER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:J
Other - Last Name:CHAMPION
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:2430 EMERALD PL STE 201
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-5743
Mailing Address - Country:US
Mailing Address - Phone:252-752-2140
Mailing Address - Fax:252-689-6502
Practice Address - Street 1:2430 EMERALD PL STE 201
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-5743
Practice Address - Country:US
Practice Address - Phone:252-752-2140
Practice Address - Fax:252-689-6502
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC138530163W00000X
NC51773367500000X
NC2227367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC138530OtherNORTH CAROLINA BOARD OF NURSING
51773OtherNBCRNA - BOARD CERTIFICATION