Provider Demographics
NPI:1598833295
Name:BAKER, BARBARA S (ARNP)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:S
Last Name:BAKER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 BROADBILL CT
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40324-9294
Mailing Address - Country:US
Mailing Address - Phone:859-619-5488
Mailing Address - Fax:
Practice Address - Street 1:103 BOSTON SQ
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:KY
Practice Address - Zip Code:40324-9746
Practice Address - Country:US
Practice Address - Phone:859-619-5488
Practice Address - Fax:502-570-9269
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3004916363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY3004916OtherAPRN
KY0927163Medicare PIN