Provider Demographics
NPI:1912402561
Name:BAKER, NATALIE JOANN (NP)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:JOANN
Last Name:BAKER
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 1:2313 E HILL RD
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-5059
Mailing Address - Country:US
Mailing Address - Phone:810-496-0900
Mailing Address - Fax:810-695-6497
Practice Address - Street 1:2313 E HILL RD
Practice Address - Street 2:
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-5059
Practice Address - Country:US
Practice Address - Phone:810-496-0900
Practice Address - Fax:810-695-6497
Is Sole Proprietor?:No
Enumeration Date:2018-03-27
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704288319363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily