Provider Demographics
NPI:1619636792
Name:BAKER, HANNAH MAE (LM, CPM)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:MAE
Last Name:BAKER
Suffix:
Gender:F
Credentials:LM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1879 NE 29TH ST
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34479-2921
Mailing Address - Country:US
Mailing Address - Phone:352-789-5559
Mailing Address - Fax:
Practice Address - Street 1:15701 SW 47TH AVENUE RD
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34473-3177
Practice Address - Country:US
Practice Address - Phone:352-519-3969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-15
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL427176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty