Individual
BETHANY W BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSR PRACTITIONER
Contact information
Practice address
325 PUBLIC ST, PROVIDENCE, RI 02905-2340
(401) 752-2693
(401) 752-2694
Mailing address
375 ALLENS AVE, PROVIDENCE, RI 02905-5010
(401) 444-0400
(401) 444-0468
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APRN01017
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
BB57895
—
RI
Enumeration date
01/12/2006
Last updated
03/30/2021
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