Individual
KATHLEEN G BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
1 CONVENTION AVE, 4 PENN TOWER, PHILADELPHIA, PA 19104-4311
(215) 662-6488
Mailing address
1 CONVENTION AVE, 4 PENN TOWER, PHILADELPHIA, PA 19104-4311
(215) 662-6488
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
TP003068C
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
440771
MLHC MEDICARE AA
RI
Enumeration date
09/13/2006
Last updated
08/14/2015
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