Provider Demographics
NPI:1659379873
Name:BAKER, RAYMOND EDWARD (CRNA)
Entity type:Individual
Prefix:
First Name:RAYMOND
Middle Name:EDWARD
Last Name:BAKER
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1407 BORGER ST
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:79072-4735
Mailing Address - Country:US
Mailing Address - Phone:806-808-2761
Mailing Address - Fax:
Practice Address - Street 1:920 STANTON L YOUNG BLVD STE 1140
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-5036
Practice Address - Country:US
Practice Address - Phone:405-271-4351
Practice Address - Fax:405-271-8665
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2025-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28124995A367500000X
OK224196367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200862680Medicaid
IN200865680Medicaid
INM400044815Medicare PIN
INM400025419Medicare PIN
IN200862680Medicaid