Provider Demographics
NPI:1902109879
Name:BAKER, PAULA LOUISE (CPNP)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:LOUISE
Last Name:BAKER
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3841 PIPER STREET
Mailing Address - Street 2:SUITE T4-054
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508
Mailing Address - Country:US
Mailing Address - Phone:907-562-6228
Mailing Address - Fax:907-562-6868
Practice Address - Street 1:3841 PIPER STREET
Practice Address - Street 2:SUITE T4-054
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508
Practice Address - Country:US
Practice Address - Phone:907-562-6228
Practice Address - Fax:907-562-6868
Is Sole Proprietor?:No
Enumeration Date:2010-12-14
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX605415363LP0200X, 363L00000X
AK116349363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX875N71OtherBCBS