Agalia Renea Baker, APN
Individual provider Active NPI Family Nurse Practitioner · Russellville, AR
NPI 1821245069 · NPPES record last updated Aug 19, 2008
Key facts
- NPI
- 1821245069
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- A03093 ANP (AR)
- Practice address
- 350 Walleye Dr
Russellville, AR 72802-7282 - Phone
- (479) 498-2670
- NPI assigned
- Aug 19, 2008
- 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)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A03093 ANP | AR | MD | Family Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | A03093 ANP | AR | Yes |
Addresses
Primary practice location
350 Walleye Dr
Russellville, AR 72802-7282
Mailing address
350 Walleye Dr
Russellville, AR 72802-7282
Phone (479) 498-2670
Other providers in Russellville, AR
- Azure Health LLC
- James L Babcock
- Alison Babitzke
- Madria Bagby
- Scott Bailey
- Ashley Nicole Baker
- Ashley Renee Baker
- Dana E Baker
- Dustin Baker
- James Baker
All providers in Russellville, AR · Family Nurse Practitioner in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 19, 2008. 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.