Individual
MRS. JACQUELYN ROSE BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
240 MEDICAL PARK BLVD STE 3700, BRISTOL, TN 37620-7350
(423) 274-6365
(423) 990-2492
Mailing address
PO BOX 9, KINGSPORT, TN 37662-0009
(423) 857-2093
(423) 390-3340
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
23759
TN
363LF0000X
Family Nurse Practitioner
Primary
23759
TN
Other
Enumeration date
06/08/2018
Last updated
10/15/2019
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