Provider Demographics
NPI:1316334303
Name:BAKER, CATHY LYNN (REGISTERED NURSE)
Entity type:Individual
Prefix:MRS
First Name:CATHY
Middle Name:LYNN
Last Name:BAKER
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:290 S CENTER ST
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-5219
Mailing Address - Country:US
Mailing Address - Phone:410-876-4800
Mailing Address - Fax:
Practice Address - Street 1:290 S CENTER ST
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-5219
Practice Address - Country:US
Practice Address - Phone:410-876-4800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-17
Last Update Date:2015-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR108058163W00000X, 163WA0400X, 163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator
No163W00000XNursing Service ProvidersRegistered Nurse
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)