Provider Demographics
NPI:1760605034
Name:BAKER, MARK STEVEN (LPN)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:STEVEN
Last Name:BAKER
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
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Mailing Address - Street 1:5612 CREEK POINT DR
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-7090
Mailing Address - Country:US
Mailing Address - Phone:828-322-2050
Mailing Address - Fax:828-324-4276
Practice Address - Street 1:3521 GRAYSTONE PL
Practice Address - Street 2:
Practice Address - City:CONOVER
Practice Address - State:NC
Practice Address - Zip Code:28613-8201
Practice Address - Country:US
Practice Address - Phone:828-322-2050
Practice Address - Fax:828-324-4271
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC156FX1100X156FX1100X
NC018088164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered156FX1100XEye and Vision Services ProvidersTechnician/TechnologistOphthalmic
Not Answered164W00000XNursing Service ProvidersLicensed Practical Nurse