Provider Demographics
NPI:1265725915
Name:BAKER, ANDREA NICOLE (RN)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:NICOLE
Last Name:BAKER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 SMITHFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-5858
Mailing Address - Country:US
Mailing Address - Phone:740-252-0038
Mailing Address - Fax:
Practice Address - Street 1:509 SMITHFIELD AVE
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-5858
Practice Address - Country:US
Practice Address - Phone:740-252-0038
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-26
Last Update Date:2011-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.350013163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse