Provider Demographics
NPI:1457909459
Name:BAKER, BEATRICE MARIE (ATTENDANT PROVIDER)
Entity type:Individual
Prefix:
First Name:BEATRICE
Middle Name:MARIE
Last Name:BAKER
Suffix:
Gender:F
Credentials:ATTENDANT PROVIDER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1510 CLEMENTSON DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78260-6280
Mailing Address - Country:US
Mailing Address - Phone:850-648-8201
Mailing Address - Fax:
Practice Address - Street 1:1510 CLEMENTSON DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78260-6280
Practice Address - Country:US
Practice Address - Phone:850-648-8201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-03
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider