Provider Demographics
NPI:1841629888
Name:BAKER, DARLYN (APN)
Entity type:Individual
Prefix:
First Name:DARLYN
Middle Name:
Last Name:BAKER
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5090 CHAISE DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80923-8711
Mailing Address - Country:US
Mailing Address - Phone:719-649-1902
Mailing Address - Fax:719-960-2407
Practice Address - Street 1:5353 N UNION BLVD STE 202
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-2069
Practice Address - Country:US
Practice Address - Phone:719-649-1902
Practice Address - Fax:719-960-2407
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-08
Last Update Date:2020-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.0086998163W00000X
COAPN0995448-NP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse