Provider Demographics
NPI:1629794268
Name:BAKER, SCARLETT (NP)
Entity Type:Individual
Prefix:
First Name:SCARLETT
Middle Name:
Last Name:BAKER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2231 PALMETTO GLEN DR APT 313
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-7440
Mailing Address - Country:US
Mailing Address - Phone:804-385-7788
Mailing Address - Fax:
Practice Address - Street 1:2231 PALMETTO GLEN DR APT 313
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-7440
Practice Address - Country:US
Practice Address - Phone:804-385-7788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-17
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11021951363LF0000X
FLF08221301363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily