Provider Demographics
NPI:1982844718
Name:BAKER, NORA M (MA/CCC)
Entity Type:Individual
Prefix:
First Name:NORA
Middle Name:M
Last Name:BAKER
Suffix:
Gender:F
Credentials:MA/CCC
Other - Prefix:
Other - First Name:NORA
Other - Middle Name:
Other - Last Name:MANDELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:313 BOWLINE CT
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-3116
Mailing Address - Country:US
Mailing Address - Phone:515-656-9197
Mailing Address - Fax:
Practice Address - Street 1:313 BOWLINE CT
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-3116
Practice Address - Country:US
Practice Address - Phone:515-656-9197
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-06
Last Update Date:2015-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50419231H00000X
CO0000731231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX292197YKXYMedicare PIN
TX292197YKXVMedicare PIN
TX8L20097Medicare PIN
TX292197YSSPMedicare PIN