Individual
JACQUELINE BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
134 STATE ST, MERIDEN, CT 06450-3293
(203) 237-2229
(203) 686-1677
Mailing address
575 MAIN STREET 2ND FLOOR, ATTN; CREDENTIALING DEPT, MIDDLETOWN, CT 06457
(860) 347-6971
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
002812
CT
363LF0000X
Family Nurse Practitioner
Primary
002812
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004235900
—
CT
05
—
004236346
—
CT
Enumeration date
05/17/2007
Last updated
06/21/2013
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