Provider Demographics
NPI:1164396198
Name:BAKER, MIRENEA ALEXANDRIA (PERINATAL DOULA)
Entity type:Individual
Prefix:
First Name:MIRENEA
Middle Name:ALEXANDRIA
Last Name:BAKER
Suffix:
Gender:F
Credentials:PERINATAL DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 E 26TH ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16504-1003
Mailing Address - Country:US
Mailing Address - Phone:814-812-3630
Mailing Address - Fax:
Practice Address - Street 1:301 E 26TH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16504-1003
Practice Address - Country:US
Practice Address - Phone:814-812-3630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-02
Last Update Date:2025-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA22241374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula