Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | SP021427 | PA |
NPI | 1003447368 |
---|---|
Provider Name | Kaylee Morgan Baker |
First Address | Philadelphia, PA 19104-5127 |
Second Address | Philadelphia, PA 19104-4310 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2020 |
Last Update Date | 01/12/2020 |