Provider Demographics
NPI:1790167344
Name:BAKER, KRISTIN A (DNP, ARNP)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:A
Last Name:BAKER
Suffix:
Gender:F
Credentials:DNP, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 ASH CT
Mailing Address - Street 2:
Mailing Address - City:NORTH LIBERTY
Mailing Address - State:IA
Mailing Address - Zip Code:52317-9316
Mailing Address - Country:US
Mailing Address - Phone:563-495-4445
Mailing Address - Fax:
Practice Address - Street 1:855 A AVE NE STE 400
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-5064
Practice Address - Country:US
Practice Address - Phone:319-363-3565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-19
Last Update Date:2017-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA125801363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily