Provider Demographics
NPI:1982000766
Name:BAKER, CARRIE R (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:R
Last Name:BAKER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3785 ELM DR
Mailing Address - Street 2:
Mailing Address - City:PEARL CITY
Mailing Address - State:HI
Mailing Address - Zip Code:96782-3984
Mailing Address - Country:US
Mailing Address - Phone:276-806-3226
Mailing Address - Fax:
Practice Address - Street 1:727 WAINEE ST STE 201
Practice Address - Street 2:
Practice Address - City:LAHAINA
Practice Address - State:HI
Practice Address - Zip Code:96761-1589
Practice Address - Country:US
Practice Address - Phone:808-280-4192
Practice Address - Fax:877-273-2946
Is Sole Proprietor?:No
Enumeration Date:2014-11-06
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1670363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health