Individual
MRS. AMANDA RAE BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6901 MARKET ST, ATTN: CREDENTIALING, WILMINGTON, NC 28411-9727
(866) 389-2727
(401) 770-4473
Mailing address
6604 WHEATFIELDS CT, WILMINGTON, NC 28411-6187
(910) 995-2872
(401) 652-2160
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-01281
NC
363AM0700X
Medical Physician Assistant
0010-01281
NC
Other
Enumeration date
03/04/2008
Last updated
09/05/2013
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