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Individual

IRENE T BAKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
1540 LAKE LANSING RD, SUITE 205, LANSING, MI 48912-3756
(517) 913-3910
(517) 913-3911
Mailing address
1540 LAKE LANSING RD, SUITE 205, LANSING, MI 48912-3756
(517) 913-3910
(517) 913-3911

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704111052
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0N55170009
MEDICARE PLUS BLUE
MI
01
1024246
MCLAREN HEALTH ADVANTAGE
MI
05
1033143417
MI
01
200000001200
PHP
MI
01
5008769750
BLUE CROSS BLUE SHIELD OF MICHIGAN
MI
01
7272662
AETNA
MI
Enumeration date
07/10/2006
Last updated
08/03/2010
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