Provider Demographics
NPI:1710562384
Name:BAKER, DIAN ADELLE
Entity Type:Individual
Prefix:
First Name:DIAN
Middle Name:ADELLE
Last Name:BAKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53480 YORK DR
Mailing Address - Street 2:
Mailing Address - City:POWHATAN POINT
Mailing Address - State:OH
Mailing Address - Zip Code:43942-9752
Mailing Address - Country:US
Mailing Address - Phone:740-310-2935
Mailing Address - Fax:
Practice Address - Street 1:53480 YORK DR
Practice Address - Street 2:
Practice Address - City:POWHATAN POINT
Practice Address - State:OH
Practice Address - Zip Code:43942-9752
Practice Address - Country:US
Practice Address - Phone:740-310-2935
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-15
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care