Provider Demographics
NPI:1992525265
Name:BAKER, ALANNE SHAYE (MMS, PA-C)
Entity type:Individual
Prefix:MRS
First Name:ALANNE
Middle Name:SHAYE
Last Name:BAKER
Suffix:
Gender:F
Credentials:MMS, PA-C
Other - Prefix:MS
Other - First Name:ALANNE
Other - Middle Name:SHAYE
Other - Last Name:FRANCIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1650 LIBERTY DR STE 100
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27360-5375
Mailing Address - Country:US
Mailing Address - Phone:336-625-8410
Mailing Address - Fax:336-475-8405
Practice Address - Street 1:1650 LIBERTY DR STE 100
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:NC
Practice Address - Zip Code:27360-5375
Practice Address - Country:US
Practice Address - Phone:336-475-8410
Practice Address - Fax:336-475-8405
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-11
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty