Individual
JACQUELINE BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
4700 WISSAHICKON AVE STE 110, PHILADELPHIA, PA 19144-4252
(267) 597-3600
Mailing address
4700 WISSAHICKON AVE STE 118, PHILADELPHIA, PA 19144-4248
(267) 597-3600
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
SP021672
PA
Other
Enumeration date
03/27/2020
Last updated
12/08/2021
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