Individual
MR. CHESTER RILEY BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP RN CS
Contact information
Practice address
130 MAGNOLIA LN, CORNELIA, GA 30531-2241
(706) 776-3070
(706) 776-3788
Mailing address
130 B MAGNOLIA LANE, CORNELIA, GA 30531
(706) 776-3070
(706) 776-3788
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
146348
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
035805515A
—
GA
Enumeration date
10/24/2005
Last updated
09/09/2009
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