Individual
JACQUELYNN DANIELLE BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
915 N GRAND BLVD, SAINT LOUIS, MO 63106-1621
(314) 652-4100
(314) 289-7058
Mailing address
915 N GRAND BLVD, SAINT LOUIS, MO 63106-1621
(314) 652-4100
(143) 289-7058
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
114211
MO
Other
Enumeration date
03/19/2007
Last updated
03/14/2025
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