Provider Demographics
NPI:1609449602
Name:BAKER, NINA SUZANNE (DPT, MS)
Entity Type:Individual
Prefix:
First Name:NINA
Middle Name:SUZANNE
Last Name:BAKER
Suffix:
Gender:F
Credentials:DPT, MS
Other - Prefix:
Other - First Name:NINA
Other - Middle Name:SUZANNE
Other - Last Name:ZDANOWICZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT, MS
Mailing Address - Street 1:PO BOX 3276
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47731-3276
Mailing Address - Country:US
Mailing Address - Phone:812-473-0181
Mailing Address - Fax:812-473-5822
Practice Address - Street 1:201 SE 4TH ST, SUITE 150
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47713-1350
Practice Address - Country:US
Practice Address - Phone:812-461-6716
Practice Address - Fax:812-402-1250
Is Sole Proprietor?:No
Enumeration Date:2021-07-19
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05014228A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist