Individual
CEDAR KRUESI BROCK BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
275 COLLIER RD NW STE 300, ATLANTA, GA 30309-1740
(404) 350-0009
Mailing address
1462 CLIFTON RD NE, ATLANTA, GA 30322-1063
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
11433
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/22/2021
Last updated
04/18/2023
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