Individual
MICHELLE LOVE-BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2401 S 31ST ST, TEMPLE, TX 76508-3596
(254) 724-2111
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
(254) 724-2111
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
747788
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
AP116481
TX
367500000X
Certified Registered Nurse Anesthetist
R0069073
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100785940A
—
OK
01
—
487917900
DEPT OF LABOR
OK
01
—
DA6664
MEDICARE RR
OK
Enumeration date
09/05/2006
Last updated
08/01/2024
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