Provider Demographics
NPI:1649439993
Name:BAKER, MELISSA FAITH (APN-BC)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:FAITH
Last Name:BAKER
Suffix:
Gender:F
Credentials:APN-BC
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:
Other - Last Name:LIEF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:92 2ND ST
Mailing Address - Street 2:SECOND FLOOR, ROOM 250
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-2105
Mailing Address - Country:US
Mailing Address - Phone:201-996-5900
Mailing Address - Fax:551-996-0575
Practice Address - Street 1:92 2ND ST
Practice Address - Street 2:SECOND FLOOR, ROOM 250
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-2105
Practice Address - Country:US
Practice Address - Phone:201-996-5900
Practice Address - Fax:551-996-0575
Is Sole Proprietor?:No
Enumeration Date:2008-06-03
Last Update Date:2011-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00158800363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health