Individual
GWENDOLYN ANN BAKER
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
L.P.N.
Contact information
Practice address
62440 CUMBERLAND RUN RD, JACOBSBURG, OH 43933-9717
(740) 686-2199
Mailing address
3981 HIGHLAND AVE, SHADYSIDE, OH 43947-1256
(740) 676-2002
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN064334
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2175266
—
OH
Enumeration date
04/27/2006
Last updated
07/08/2007
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