Provider Demographics
NPI:1841534161
Name:BAKERMAN, EMILY ANN (NP)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:ANN
Last Name:BAKERMAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:552 STELLMAN RD
Mailing Address - Street 2:
Mailing Address - City:RIVERVALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07675-6126
Mailing Address - Country:US
Mailing Address - Phone:201-320-4222
Mailing Address - Fax:201-930-0945
Practice Address - Street 1:552 STELLMAN RD
Practice Address - Street 2:
Practice Address - City:RIVERVALE
Practice Address - State:NJ
Practice Address - Zip Code:07675-6126
Practice Address - Country:US
Practice Address - Phone:201-320-4222
Practice Address - Fax:201-930-0945
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-27
Last Update Date:2012-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00402100363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health