Individual
KENNETH W BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
3917 W CAMP WISDOM RD, DALLAS, TX 75237-2468
(972) 709-7259
(972) 709-7252
Mailing address
2905 DAVIS DR, MIDLOTHIAN, TX 76065-9162
(817) 991-9730
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
577002
TX
Other
Enumeration date
09/20/2006
Last updated
02/23/2010
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