Carly Jean Baker
Individual provider Active NPI Licensed Practical Nurse · Sparta, WI
NPI 1710293204 · NPPES record last updated Aug 23, 2010
Key facts
- NPI
- 1710293204
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- 302971-031 (WI)
- Practice address
- 510 N Court St
Sparta, WI 54656-1708 - Phone
- (608) 633-3333
- NPI assigned
- Aug 23, 2010
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 302971-031 | WI | MD | Licensed Practical Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carly Baker | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 302971-031 | WI | Yes |
Addresses
Primary practice location
510 N Court St
Sparta, WI 54656-1708
Mailing address
146 Tilson St E
West Salem, WI 54669-1213
Phone (608) 792-2646
Other providers in Sparta, WI
- Mitchell A Anderson
- Mercedes Lynn Antolak
- Zachary C April
- Atlas Chiropractic Clinic SC
- Badgerland Emergency Medical Services
- Katarzyna Baluta
- Rob N Bean
- Dennis Austin Paul Bernau
- Megan Berner
- Pauline J. Berra
All providers in Sparta, WI · Licensed Practical Nurse in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 23, 2010. 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.