Provider Demographics
NPI:1922769090
Name:GATES-BAKER, DENISE D (RN)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:D
Last Name:GATES-BAKER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5796 JUBILANT DR
Mailing Address - Street 2:
Mailing Address - City:REX
Mailing Address - State:GA
Mailing Address - Zip Code:30273-1578
Mailing Address - Country:US
Mailing Address - Phone:678-834-5396
Mailing Address - Fax:404-489-6817
Practice Address - Street 1:5796 JUBILANT DR
Practice Address - Street 2:
Practice Address - City:REX
Practice Address - State:GA
Practice Address - Zip Code:30273-1578
Practice Address - Country:US
Practice Address - Phone:678-641-3497
Practice Address - Fax:404-489-6817
Is Sole Proprietor?:No
Enumeration Date:2021-12-31
Last Update Date:2021-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN113876163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care