Provider Demographics
NPI:1629533930
Name:BAKER, RACHEL (APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:BAKER
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:
Other - Last Name:UTENDORF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5451 KETUKKEE TRL
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43611-1630
Mailing Address - Country:US
Mailing Address - Phone:419-265-1605
Mailing Address - Fax:
Practice Address - Street 1:7640 SYLVANIA AVE STE L
Practice Address - Street 2:
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-9263
Practice Address - Country:US
Practice Address - Phone:567-455-5906
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-31
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH023276363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily