Individual
BECKY BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2016 S MAIN ST, MARYVILLE, MO 64468-2655
(660) 562-2600
(660) 562-7911
Mailing address
114 E SOUTH HILLS DR, MARYVILLE, MO 64468-2659
(660) 562-2600
(660) 562-7911
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
A079775
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A079775
LICENSE
IA
Enumeration date
03/20/2014
Last updated
01/06/2017
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