Provider Demographics
NPI:1629263157
Name:BAKER, MELISSA B (CPHT)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:B
Last Name:BAKER
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:298 PERKINS RD SE
Mailing Address - Street 2:
Mailing Address - City:VALDESE
Mailing Address - State:NC
Mailing Address - Zip Code:28690-9403
Mailing Address - Country:US
Mailing Address - Phone:828-580-5460
Mailing Address - Fax:828-580-5459
Practice Address - Street 1:3492 SHERWOOD HEIGHTS
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655
Practice Address - Country:US
Practice Address - Phone:828-437-5696
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-07
Last Update Date:2007-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC06343183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician