Provider Demographics
NPI:1861656811
Name:BAKER, NANCY L (RNBC)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:L
Last Name:BAKER
Suffix:
Gender:F
Credentials:RNBC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 JAQUES AVE
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01610
Mailing Address - Country:US
Mailing Address - Phone:978-343-6957
Mailing Address - Fax:978-343-0449
Practice Address - Street 1:255 MAIN ST
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:MA
Practice Address - Zip Code:01420-4331
Practice Address - Country:US
Practice Address - Phone:978-343-6957
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-17
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA69752101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
M18723OtherBLUE CROSS OF MASS
MA042626179OtherTRICARE
MA1303007Medicaid
MA66992OtherCIGNA
MA997527OtherNEIGHBORHOOD HEALTH
MA1000830OtherFALLON
MA600673OtherTUFTS
MA4294OtherMAGELLAN