Individual
JACKLYN AMY BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
306 W 3RD ST UNIT B, GILLETTE, WY 82716-3603
(307) 363-4040
Mailing address
1304 MANCHESTER ST, GILLETTE, WY 82716-2865
(520) 603-1946
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
53757
WY
Other
Enumeration date
02/08/2024
Last updated
02/08/2024
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