Provider Demographics
NPI:1609110519
Name:BAKER, SANDRA KROL (WHNP-BC)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:KROL
Last Name:BAKER
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 ELSTOW CT
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27519-9522
Mailing Address - Country:US
Mailing Address - Phone:919-244-4213
Mailing Address - Fax:
Practice Address - Street 1:EXPRESS TEST NC, LLC
Practice Address - Street 2:110 SWIFT AVE
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705
Practice Address - Country:US
Practice Address - Phone:919-809-9885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-15
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5005962363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health