Provider Demographics
NPI:1316287352
Name:BAKER, KELLY LIND
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:LIND
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 1:9622 STOCKPORT CIR
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29485-9006
Mailing Address - Country:US
Mailing Address - Phone:757-615-5949
Mailing Address - Fax:
Practice Address - Street 1:9622 STOCKPORT CIR
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29485-9006
Practice Address - Country:US
Practice Address - Phone:757-615-5949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-28
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula