Matthew Dickie Baker, RN
Individual provider Active NPI Registered Nurse · Fort Wayne, IN
NPI 1053050765 · NPPES record last updated Jun 1, 2022
Key facts
- NPI
- 1053050765
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 28145667A (IN)
- Practice address
- 2121 Lake Ave
Fort Wayne, IN 46805-5100 - Phone
- (260) 426-5431
- NPI assigned
- Jun 1, 2022
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28145667A | IN | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 28145667A | IN | Yes |
Addresses
Primary practice location
2121 Lake Ave
Fort Wayne, IN 46805-5100
Mailing address
2121 Lake Ave
Fort Wayne, IN 46805-5100
Phone (260) 426-5431
Other providers in Fort Wayne, IN
- David R Baker
- Gillian Baker
- Jennifer Kay Baker
- Julia Baker
- Laura Beth Baker
- Michael J Baker
- Rachel Marie Baker
- Ronald L Baker
- Samantha Marie Baker
- Whitney Cristine Baker
All providers in Fort Wayne, IN · Registered Nurse in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 1, 2022. 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.