Individual
MRS. CAROLYN ANNE BAKER
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1048 KALFAHS ST, NEENAH, WI 54956-4110
(920) 720-0176
Mailing address
N 2955 BIRCHWOOD DR, CAMPBELLSPORT, WI 53010-1858
(920) 533-4775
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
16641031
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38287700
—
WI
Enumeration date
06/07/2006
Last updated
07/08/2007
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