Katheryn Ann Baker

Individual provider Active NPI Community Health Registered Nurse · Fruitland, MD

NPI 1003050808 · NPPES record last updated Apr 23, 2009

Key facts

NPI
1003050808
Entity type
Individual (NPI type 1)
Primary specialty
Community Health Registered Nurse 163WC1500X
License
R121393 (MD)
Practice address
213 Garrisonway
Fruitland, MD 21826
Phone
(502) 413-5841
NPI assigned
Apr 23, 2009
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
R121393MDMDCommunity Health Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X R121393 MD Yes

Addresses

Primary practice location

213 Garrisonway
Fruitland, MD 21826

Mailing address

C Co 302 BSB Attn: TMC
Unit 15609
Apo, AP 96224
Phone (502) 413-5841

Other names

  • Katheryn Ann Baker Former name

Other providers in Fruitland, MD

All providers in Fruitland, MD · Community Health Registered Nurse in Maryland

Sources for this page

Verify at the official NPI Registry.