Individual
KRYSTAL BAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2301 W THOMAS RD, PHOENIX, AZ 85015-5904
(602) 257-3880
Mailing address
11015 W ELM LN, AVONDALE, AZ 85323-8366
(480) 233-4745
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP047817
AZ
Other
Enumeration date
02/16/2018
Last updated
02/16/2018
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