Provider Demographics
NPI:1619326709
Name:BAKER, DEBRA (APRN)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:
Last Name:BAKER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:
Other - Last Name:MORGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3301 WOODS DR
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:NE
Mailing Address - Zip Code:68025-2186
Mailing Address - Country:US
Mailing Address - Phone:402-720-8691
Mailing Address - Fax:402-816-4036
Practice Address - Street 1:3140 ELK LN STE 600
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:NE
Practice Address - Zip Code:68025
Practice Address - Country:US
Practice Address - Phone:402-720-8691
Practice Address - Fax:402-816-4036
Is Sole Proprietor?:No
Enumeration Date:2016-06-09
Last Update Date:2019-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE112013363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NENA1899005Medicare PIN