Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | SP009394 | PA |
NPI | 1013114503 |
---|---|
Provider Name | Giles Alan Baker |
First Address | Quakertown, PA 18951-1573 |
Second Address | Quakertown, PA 18951-1573 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2007 |
Last Update Date | 28/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
SP009394 | LICENSE (01) | PA |