Kathy Davis Baker, BSN/CPNP
Individual provider Active NPI Pediatric Nurse Practitioner · Bowling Green, KY
NPI 1043201445 · NPPES record last updated Jun 24, 2019
Key facts
- NPI
- 1043201445
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Nurse Practitioner 363LP0200X
- License
- 3000397 (KY)
- Practice address
- 615 7TH Ave
Bowling Green, KY 42101-6921 - Phone
- (270) 783-3573
- NPI assigned
- Nov 3, 2005
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Bachelor on Science - Nursing, Certified Pediatric Nurse Practitioner
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 3000397 | KY | Yes |
Addresses
Primary practice location
615 7TH Ave
Bowling Green, KY 42101-6921
Mailing address
PO Box 1177
Bowling Green, KY 42102-1177
Phone (270) 783-3573
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3000397 | Other | KY | KENTUCKY BOARD OF NURSING |
| 78009495 | Medicaid | KY |
Other providers in Bowling Green, KY
- Grace Kimrey Baird
- Arrsh Bajaj
- Abigail Baker
- Brent T Baker
- Kaitlyn M. Baker
- Mary Jo D. Baker
- Terry Randall Baker
- Balance Therapeutic Care, Counseling Services LLC
- John W Balchunas
- Jonathon Baldwin
All providers in Bowling Green, KY · Pediatric Nurse Practitioner in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 24, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.