Provider Demographics
NPI:1952417842
Name:BAKER, GLADYS MILDRED (REGISTERED NURSE)
Entity Type:Individual
Prefix:MRS
First Name:GLADYS
Middle Name:MILDRED
Last Name:BAKER
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:MRS
Other - First Name:GLADYS
Other - Middle Name:M
Other - Last Name:TOMSHAW BAKER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:PO BOX 1594
Mailing Address - Street 2:
Mailing Address - City:BELLEVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:34421-1594
Mailing Address - Country:US
Mailing Address - Phone:352-629-0137
Mailing Address - Fax:352-694-4824
Practice Address - Street 1:1801 SE 32ND AVE
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34478
Practice Address - Country:US
Practice Address - Phone:352-629-0137
Practice Address - Fax:352-694-4824
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN1067352163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse