Provider Demographics
NPI:1982025359
Name:BAKER, KERRI (PA-C)
Entity Type:Individual
Prefix:
First Name:KERRI
Middle Name:
Last Name:BAKER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1330
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73070-1330
Mailing Address - Country:US
Mailing Address - Phone:405-307-6668
Mailing Address - Fax:405-701-6170
Practice Address - Street 1:3151 HEALTHPLEX DR
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-1001
Practice Address - Country:US
Practice Address - Phone:405-515-4099
Practice Address - Fax:405-307-5625
Is Sole Proprietor?:No
Enumeration Date:2014-01-02
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKAPA2327363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant