Provider Demographics
NPI:1457700304
Name:BAKER, REBECCA (FNP-C)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:BAKER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2471 SUNSET MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:SC
Mailing Address - Zip Code:29742-8739
Mailing Address - Country:US
Mailing Address - Phone:803-927-0643
Mailing Address - Fax:
Practice Address - Street 1:4027 WOODLAWN ST
Practice Address - Street 2:
Practice Address - City:SHARON
Practice Address - State:SC
Practice Address - Zip Code:29742-8779
Practice Address - Country:US
Practice Address - Phone:866-389-2727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-10
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC20251363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily