Provider Demographics
NPI:1548616154
Name:BAKER, CAROLYN FRANKLIN (RN)
Entity Type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:FRANKLIN
Last Name:BAKER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 WHITEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80528-8528
Mailing Address - Country:US
Mailing Address - Phone:970-223-5516
Mailing Address - Fax:
Practice Address - Street 1:1815 SUNSHINE AVE
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80504-2225
Practice Address - Country:US
Practice Address - Phone:303-827-8158
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-12
Last Update Date:2016-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0040743163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse