Provider Demographics
NPI:1467910158
Name:BAKER, BJ DENA
Entity Type:Individual
Prefix:
First Name:BJ
Middle Name:DENA
Last Name:BAKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5070 RITTER RD
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17055-4824
Mailing Address - Country:US
Mailing Address - Phone:717-590-1525
Mailing Address - Fax:717-590-1565
Practice Address - Street 1:5070 RITTER RD
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17055-4824
Practice Address - Country:US
Practice Address - Phone:717-590-1525
Practice Address - Fax:717-590-1565
Is Sole Proprietor?:No
Enumeration Date:2019-03-12
Last Update Date:2019-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN305577164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse