Provider Demographics
NPI:1760634570
Name:BAKER, RITA MARY (RN)
Entity Type:Individual
Prefix:MRS
First Name:RITA
Middle Name:MARY
Last Name:BAKER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4836 KING MEADOW TRL
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:OH
Mailing Address - Zip Code:44240-5604
Mailing Address - Country:US
Mailing Address - Phone:330-414-9175
Mailing Address - Fax:
Practice Address - Street 1:4836 KING MEADOW TRL
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:OH
Practice Address - Zip Code:44240-5604
Practice Address - Country:US
Practice Address - Phone:330-414-9175
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-13
Last Update Date:2008-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN342642163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse