Individual
MR. NEVIN E BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1850 BLUEGRASS AVE, ANESTHESIA DEPARTMENT, LOUISVILLE, KY 40215-1161
(502) 367-3360
(502) 367-3365
Mailing address
100 E LIBERTY ST, SUITE 800, LOUISVILLE, KY 40202-1434
(502) 361-6617
(502) 361-6637
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
3004780
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000945233 (KOHMG)
ANTHEM
KY
01
—
051620
KENTUCKY
KY
05
—
201183190 (KOHMG)
—
IN
05
—
74012204 (KOHMG)
—
KY
Enumeration date
06/21/2006
Last updated
04/19/2018
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