Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC1500X | Nurse Practitioner - Community Health | 44112 | KS |
NPI | 1730393109 |
---|---|
Provider Name | Margaret Baker |
First Address | Wichita, KS 67204-5432 |
Second Address | Wichita, KS 67214-3115 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2007 |
Last Update Date | 08/07/2007 |