Individual
STEPHANIE NIELSEN BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
229 S 7TH ST, ST MARIES, ID 83861-1803
(208) 245-2591
Mailing address
229 S 7TH ST, ST MARIES, ID 83861-1803
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
56789
ID
Other
Enumeration date
08/30/2017
Last updated
08/30/2017
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