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Individual

DALTON DEAN BAKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
512 N NEW ST, KIRKSVILLE, MO 63501-3167
(660) 988-4723
Mailing address
512 N NEW ST, KIRKSVILLE, MO 63501-3167

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2013022156
MO
363LF0000X
Family Nurse Practitioner
Primary
A149860
IA

Other

Enumeration date
11/30/2017
Last updated
09/09/2020
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