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Individual

KATHLEEN M BAKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNP

Contact information

Practice address
1730 W 25TH ST, CLEVELAND, OH 44113-3108
(216) 696-4300
Mailing address
PO BOX 74216, CLEVELAND, OH 44194-0002
(440) 879-0081
(440) 879-0084

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NP-01301
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000325965
ANTHEM
OH
05
2199482
OH
Enumeration date
02/08/2006
Last updated
04/30/2008
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