Individual
MR. KENNETH LEE BAKER II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BSN, RN
Contact information
Practice address
2501 KENTUCKY AVE, PADUCAH, KY 42003-3813
(270) 575-2887
Mailing address
502 N 5TH ST, VIENNA, IL 62995-1630
(618) 201-3958
Taxonomy
Speciality
Code
Description
License number
State
163WC1600X
Continuing Education/Staff Development Registered Nurse
Primary
1159765
KY
163WE0003X
Emergency Registered Nurse
041442571
IL
Other
Enumeration date
10/05/2023
Last updated
10/05/2023
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