Individual
CANDICE J. BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
F.N.P.
Contact information
Practice address
1602 N 2ND ST, CLINTON, MO 64735-1192
(660) 885-8171
Mailing address
1602 N 2ND ST, CLINTON, MO 64735-1192
(660) 885-8171
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
066060
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31726018
BCBS SERVICING PROVIDER#
MO
05
—
427971510
—
MO
Enumeration date
10/12/2005
Last updated
08/25/2014
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