Basic Information
| Provider Information | |||||||||
| NPI: | 1942519525 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BAKER | ||||||||
| FirstName: | HAYLEY | ||||||||
| MiddleName: | MARIE | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | FNP | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 9249 W LAKE CITY RD | ||||||||
| Address2: | |||||||||
| City: | HOUGHTON LAKE | ||||||||
| State: | MI | ||||||||
| PostalCode: | 486299602 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9894225122 | ||||||||
| FaxNumber: | 9894224378 | ||||||||
| Practice Location | |||||||||
| Address1: | 9249 W LAKE CITY RD | ||||||||
| Address2: | |||||||||
| City: | HOUGHTON LAKE | ||||||||
| State: | MI | ||||||||
| PostalCode: | 486299602 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9894225122 | ||||||||
| FaxNumber: | 9894224378 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/30/2010 | ||||||||
| LastUpdateDate: | 08/28/2020 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialTitleorPosition: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/28/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 4704226766 | MI | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.