Provider Demographics
NPI:1942684493
Name:BAKER, ABIGAIL (AGACNP)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:BAKER
Suffix:
Gender:F
Credentials:AGACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9934 KENNEBEC RD
Mailing Address - Street 2:
Mailing Address - City:WILLOW SPRING
Mailing Address - State:NC
Mailing Address - Zip Code:27592-9422
Mailing Address - Country:US
Mailing Address - Phone:513-317-6147
Mailing Address - Fax:
Practice Address - Street 1:9934 KENNEBEC RD
Practice Address - Street 2:
Practice Address - City:WILLOW SPRING
Practice Address - State:NC
Practice Address - Zip Code:27592-9422
Practice Address - Country:US
Practice Address - Phone:513-317-6147
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-15
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95002710363LA2100X
NC5018974363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care