Provider Demographics
NPI:1336792522
Name:BAKER, DEB
Entity Type:Individual
Prefix:
First Name:DEB
Middle Name:
Last Name:BAKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10531 RIVER OAKS DR
Mailing Address - Street 2:
Mailing Address - City:PERRYSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43551-1694
Mailing Address - Country:US
Mailing Address - Phone:419-661-1056
Mailing Address - Fax:419-931-4085
Practice Address - Street 1:10531 RIVER OAKS DR
Practice Address - Street 2:
Practice Address - City:PERRYSBURG
Practice Address - State:OH
Practice Address - Zip Code:43551-1694
Practice Address - Country:US
Practice Address - Phone:419-661-1056
Practice Address - Fax:419-931-4085
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-17
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.424326163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse