Provider Demographics
NPI:1144267808
Name:BAKER, CAROL ELAINE (NP-C)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:ELAINE
Last Name:BAKER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 LOHMANS SPUR
Mailing Address - Street 2:SUITE 106
Mailing Address - City:LAKEWAY
Mailing Address - State:TX
Mailing Address - Zip Code:78734-6206
Mailing Address - Country:US
Mailing Address - Phone:512-263-7133
Mailing Address - Fax:512-263-0451
Practice Address - Street 1:2300 LOHMANS SPUR
Practice Address - Street 2:SUITE 106
Practice Address - City:LAKEWAY
Practice Address - State:TX
Practice Address - Zip Code:78734-6206
Practice Address - Country:US
Practice Address - Phone:512-263-7133
Practice Address - Fax:512-263-0451
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX250654363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily