Most Relevant Information
Provider Data
| NPI Number: | 1003817016 |
| Provider Name: | DOREATHA J BAKER CPNP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LP0200X |
| Specialty: | Nurse Practitioner |
| License Number: | R091715-1 |
Most Important Dates
| Enumeration Date: | 08/02/2005 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
347 SMITH AVE N
SAINT PAUL
MN
551022387
Practice Location Phone/Fax
| Phone: | 6512206708 |
| Fax: | 6512206589 |
Provider Mailing Location
2910 CENTRE POINTE DR
35-121A
ROSEVILLE
MN
551131182
Provider Mailing Phone/Fax
| Phone: | 6518552327 |
| Fax: | 6518552310 |