Provider Demographics
NPI:1851925614
Name:BAKER, SHIRLEY JEAN
Entity Type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:JEAN
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 1:521 WINANS AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44306-1525
Mailing Address - Country:US
Mailing Address - Phone:312-972-0064
Mailing Address - Fax:
Practice Address - Street 1:521 WINANS AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44306-1525
Practice Address - Country:US
Practice Address - Phone:312-972-0064
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-02
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider