# KATHLEEN G BAKER

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1679678825
- **Gender:** F
- **Credential:** CRNP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | TP003068C | PA | Yes |

## Other

- **Enumeration date:** 09/13/2006
- **Last updated:** 08/14/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 440771 | MLHC MEDICARE AA | RI |