Provider Demographics
NPI:1598011819
Name:BAKER, JENNIFER LYNN (FNP-C)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LYNN
Last Name:BAKER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 S COULTER ST STE B
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-0703
Mailing Address - Country:US
Mailing Address - Phone:806-355-4900
Mailing Address - Fax:806-355-4903
Practice Address - Street 1:1600 S COULTER ST STE B
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-0703
Practice Address - Country:US
Practice Address - Phone:806-355-4900
Practice Address - Fax:806-355-4903
Is Sole Proprietor?:No
Enumeration Date:2012-07-24
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP122173363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX306937906Medicaid
TX8890NKOtherBCBS
TX27581YLGWMedicare PIN
TX279581ZHVMedicare PIN