Provider Demographics
NPI:1881021376
Name:BAKER, ERIKA LAINE (ARNP)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:LAINE
Last Name:BAKER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:655 W 8TH ST # C3
Mailing Address - Street 2:CLINICAL CENTER 6TH FLOOR, SUITE 6-030
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32209-6511
Mailing Address - Country:US
Mailing Address - Phone:904-244-4242
Mailing Address - Fax:904-244-4301
Practice Address - Street 1:655 W 8TH ST # C3
Practice Address - Street 2:CLINICAL CENTER 6TH FLOOR, SUITE 6-030
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32209-6511
Practice Address - Country:US
Practice Address - Phone:904-244-4242
Practice Address - Fax:904-244-4301
Is Sole Proprietor?:No
Enumeration Date:2013-09-30
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9278781363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003184597AMedicaid
FL010555300Medicaid
FLIS314ZMedicare PIN