Provider Demographics
NPI:1114201753
Name:BAKER, ANGELA CHRISTINE (LPN)
Entity type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:CHRISTINE
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 1:5321 LOOMIS ST
Mailing Address - Street 2:NORTH EAST APT 113
Mailing Address - City:NORTH EAST
Mailing Address - State:PA
Mailing Address - Zip Code:16428-1839
Mailing Address - Country:US
Mailing Address - Phone:814-392-4118
Mailing Address - Fax:
Practice Address - Street 1:5321 LOOMIS ST
Practice Address - Street 2:NORTH EAST APT 113
Practice Address - City:NORTH EAST
Practice Address - State:PA
Practice Address - Zip Code:16428-1839
Practice Address - Country:US
Practice Address - Phone:814-392-4118
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-30
Last Update Date:2011-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN278799164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse