Provider Demographics
NPI:1598596827
Name:BAKER, ANDREW JOHN (RN)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:JOHN
Last Name:BAKER
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8607 S COVE DR
Mailing Address - Street 2:
Mailing Address - City:MAINEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45039-9301
Mailing Address - Country:US
Mailing Address - Phone:513-295-0060
Mailing Address - Fax:
Practice Address - Street 1:8607 S COVE DR
Practice Address - Street 2:
Practice Address - City:MAINEVILLE
Practice Address - State:OH
Practice Address - Zip Code:45039-9301
Practice Address - Country:US
Practice Address - Phone:513-295-0060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-08
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR10027529163W00000X, 163WA0400X, 163WC0200X
OHRN.338305163WA0400X, 163WC0200X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine