Provider Demographics
NPI:1518119007
Name:BAKER, PAULA RENEE (RN)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:RENEE
Last Name:BAKER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:PAULA
Other - Middle Name:RENEE
Other - Last Name:CORNELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2727 NELSON RD
Mailing Address - Street 2:P204
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80503-9311
Mailing Address - Country:US
Mailing Address - Phone:720-300-3126
Mailing Address - Fax:
Practice Address - Street 1:2727 NELSON RD
Practice Address - Street 2:P204
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80503-9311
Practice Address - Country:US
Practice Address - Phone:720-300-3126
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-16
Last Update Date:2008-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO115770163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse