Individual
MRS. KATHY DAVIS BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSN/CPNP
Contact information
Practice address
615 7TH AVE, BOWLING GREEN, KY 42101-6921
(270) 783-3573
Mailing address
PO BOX 1177, BOWLING GREEN, KY 42102-1177
(270) 783-3573
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
3000397
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3000397
KENTUCKY BOARD OF NURSING
KY
05
—
78009495
—
KY
Enumeration date
11/03/2005
Last updated
06/24/2019
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