Provider Demographics
NPI:1699848226
Name:BAKER, SUSAN GREENE (ARNP-C)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:GREENE
Last Name:BAKER
Suffix:
Gender:F
Credentials:ARNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7051 SOUTHPOINT PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-8709
Mailing Address - Country:US
Mailing Address - Phone:904-493-2229
Mailing Address - Fax:904-396-4546
Practice Address - Street 1:7051 SOUTHPOINT PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-8709
Practice Address - Country:US
Practice Address - Phone:904-493-2229
Practice Address - Fax:904-396-4546
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3248922363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health