Basic Information
| Provider Information | |||||||||
| NPI: | 1801982061 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | BAKER | ||||||||
| FirstName: | DEBORAH | ||||||||
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| Credential: | MSN, APN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1155 MILL ST # MCM14 | ||||||||
| Address2: | |||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 895021576 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7759825262 | ||||||||
| FaxNumber: | 7759825496 | ||||||||
| Practice Location | |||||||||
| Address1: | 8610 TECHNOLOGY WAY | ||||||||
| Address2: | |||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 895215941 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7758264900 | ||||||||
| FaxNumber: | 7758263257 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/05/2006 | ||||||||
| LastUpdateDate: | 05/20/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/20/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | APRN000883 | NV | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363LA2100X | APRN000883 | NV | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care |
ID Information
| ID | Type | State | Issuer | Description | 100510496 | 05 | NV | MEDICAID |