Provider Demographics
NPI:1124781562
Name:BAKER, NICHOLA A
Entity type:Individual
Prefix:
First Name:NICHOLA
Middle Name:A
Last Name:BAKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 HENSON DR
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35811-8837
Mailing Address - Country:US
Mailing Address - Phone:256-541-5272
Mailing Address - Fax:
Practice Address - Street 1:1800 MEDICAL CENTER PKWY STE 300
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-3261
Practice Address - Country:US
Practice Address - Phone:615-849-8004
Practice Address - Fax:615-849-1334
Is Sole Proprietor?:No
Enumeration Date:2021-10-21
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN30034363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care