Provider Demographics
NPI:1396720165
Name:BAKER, ANN W (NP)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:W
Last Name:BAKER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2121 HUGHES DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606-3845
Mailing Address - Country:US
Mailing Address - Phone:419-291-2121
Mailing Address - Fax:419-479-6017
Practice Address - Street 1:2121 HUGHES DR
Practice Address - Street 2:SUITE 300
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-3845
Practice Address - Country:US
Practice Address - Phone:419-291-2121
Practice Address - Fax:419-479-6017
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN-098047363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2203449Medicaid
OH000000379378OtherANTHEM
OH$$$$$$$$$-002OtherMMOH