Individual
ANDREW B BAKER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
777 AVENUE H, POWELL, WY 82435-2260
(307) 754-2267
Mailing address
449 MOUNTAIN VIEW ST, POWELL, WY 82435-2232
(307) 754-4559
(307) 754-7733
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
20840.283
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
312028
BLUE CROSS BLUE SHIELD
WY
05
—
4300150
—
MT
Enumeration date
10/19/2005
Last updated
07/08/2007
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