Individual
COURTNEY TALLEY BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1100 E WENDOVER AVE, GREENSBORO, NC 27405-6713
(336) 641-7777
Mailing address
1100 E WENDOVER AVE, GREENSBORO, NC 27405-6713
(336) 641-7777
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-02583
NC
363A00000X
Physician Assistant
0110003059
VA
363AM0700X
Medical Physician Assistant
0010-02583
NC
363AM0700X
Medical Physician Assistant
011003059
VA
Other
Enumeration date
07/15/2009
Last updated
10/21/2014
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