Provider Demographics
NPI:1417180175
Name:BAKER, JESSICA (PA)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:BAKER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:
Other - Last Name:BAUMCHEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:6001 SW 6TH AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66615-1004
Mailing Address - Country:US
Mailing Address - Phone:785-234-2400
Mailing Address - Fax:785-271-2220
Practice Address - Street 1:6001 SW 6TH AVE STE 110
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66615
Practice Address - Country:US
Practice Address - Phone:785-234-2400
Practice Address - Fax:785-271-2220
Is Sole Proprietor?:No
Enumeration Date:2009-08-28
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KST-02588363A00000X
KS15-01336363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant