Provider Demographics
NPI:1457659500
Name:BAKER, JULIE MARTHA (RPH)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:MARTHA
Last Name:BAKER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 WEST ST
Mailing Address - Street 2:
Mailing Address - City:RUTLAND
Mailing Address - State:VT
Mailing Address - Zip Code:05701-3258
Mailing Address - Country:US
Mailing Address - Phone:802-775-0131
Mailing Address - Fax:802-775-8543
Practice Address - Street 1:7 WEST ST
Practice Address - Street 2:
Practice Address - City:RUTLAND
Practice Address - State:VT
Practice Address - Zip Code:05701-3258
Practice Address - Country:US
Practice Address - Phone:802-775-0131
Practice Address - Fax:802-775-8543
Is Sole Proprietor?:No
Enumeration Date:2011-03-14
Last Update Date:2011-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT033.0003423183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist