Provider Demographics
NPI:1922213545
Name:BAKER, MARY MARGARET (MSN, MHS, RNC, FNP)
Entity Type:Individual
Prefix:MS
First Name:MARY MARGARET
Middle Name:
Last Name:BAKER
Suffix:
Gender:F
Credentials:MSN, MHS, RNC, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 KULI PUU PL
Mailing Address - Street 2:
Mailing Address - City:KIHEI
Mailing Address - State:HI
Mailing Address - Zip Code:96753-7166
Mailing Address - Country:US
Mailing Address - Phone:808-879-9295
Mailing Address - Fax:
Practice Address - Street 1:275 KULI PUU PL
Practice Address - Street 2:
Practice Address - City:KIHEI
Practice Address - State:HI
Practice Address - Zip Code:96753-7166
Practice Address - Country:US
Practice Address - Phone:808-879-9295
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN 877363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health