Individual
AGALIA RENEA BAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
350 WALLEYE DR, RUSSELLVILLE, AR 72802-7282
(479) 498-2670
Mailing address
350 WALLEYE DR, RUSSELLVILLE, AR 72802-7282
(479) 498-2670
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A03093 ANP
AR
Other
Enumeration date
08/19/2008
Last updated
08/19/2008
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