Provider Demographics
NPI:1023273976
Name:BAKER, CARRIE E (PA)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:E
Last Name:BAKER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 PARK DR
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:VA
Mailing Address - Zip Code:24445-2921
Mailing Address - Country:US
Mailing Address - Phone:540-839-7000
Mailing Address - Fax:
Practice Address - Street 1:106 PARK DR
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:VA
Practice Address - Zip Code:24445-2921
Practice Address - Country:US
Practice Address - Phone:540-839-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-21
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110002825363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant