Provider Demographics
NPI:1063070050
Name:BAKER, LONDON (LPN)
Entity type:Individual
Prefix:
First Name:LONDON
Middle Name:
Last Name:BAKER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3310 MARKET ST STE B
Mailing Address - Street 2:
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-4460
Mailing Address - Country:US
Mailing Address - Phone:717-412-4154
Mailing Address - Fax:717-409-8635
Practice Address - Street 1:3310 MARKET ST STE B
Practice Address - Street 2:
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-4460
Practice Address - Country:US
Practice Address - Phone:717-412-4154
Practice Address - Fax:717-409-8635
Is Sole Proprietor?:No
Enumeration Date:2019-06-04
Last Update Date:2019-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN308715164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPN308715OtherSTATE DEPARTMENT