Provider Demographics
NPI:1972515583
Name:BAKER, MARYBETH MOLLY (APRN, BC)
Entity type:Individual
Prefix:MRS
First Name:MARYBETH
Middle Name:MOLLY
Last Name:BAKER
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Gender:F
Credentials:APRN, BC
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Mailing Address - Street 1:276 CHESTNUT HILL AVE
Mailing Address - Street 2:APT. #14
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-5936
Mailing Address - Country:US
Mailing Address - Phone:617-840-2888
Mailing Address - Fax:
Practice Address - Street 1:1 HUTCHINSON DR
Practice Address - Street 2:2ND FLOOR
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-3759
Practice Address - Country:US
Practice Address - Phone:978-739-6950
Practice Address - Fax:978-777-9274
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA2006004404-21363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health