Provider Demographics
NPI:1497019459
Name:BAKER, RANCITA
Entity type:Individual
Prefix:
First Name:RANCITA
Middle Name:
Last Name:BAKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4701 LAWRENCE ST UNIT 2164
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89081-4215
Mailing Address - Country:US
Mailing Address - Phone:702-238-4385
Mailing Address - Fax:
Practice Address - Street 1:4701 LAWRENCE ST UNIT 2164
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89081-4215
Practice Address - Country:US
Practice Address - Phone:702-238-4385
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-25
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner