Provider Demographics
NPI:1598337230
Name:BAKER, OLIVIA RENAY (RN)
Entity Type:Individual
Prefix:MISS
First Name:OLIVIA
Middle Name:RENAY
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 1:2222 E CARY ST APT 524
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23223-7090
Mailing Address - Country:US
Mailing Address - Phone:210-845-8638
Mailing Address - Fax:
Practice Address - Street 1:2222 E CARY ST APT 524
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23223-7090
Practice Address - Country:US
Practice Address - Phone:210-845-8638
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-13
Last Update Date:2023-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001294595163W00000X
VA0024184573367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse