Provider Demographics
NPI:1659732865
Name:BAKER, NICOLE MAKENZIE (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:MAKENZIE
Last Name:BAKER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7201 DAVIS GREY DR
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-0210
Mailing Address - Country:US
Mailing Address - Phone:615-804-9351
Mailing Address - Fax:
Practice Address - Street 1:890 HENDERSONVILLE RD STE 200
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-1739
Practice Address - Country:US
Practice Address - Phone:828-213-9530
Practice Address - Fax:828-213-6144
Is Sole Proprietor?:No
Enumeration Date:2016-03-15
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX130113363LF0000X
NC5011225363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily