Provider Demographics
NPI:1730997636
Name:BAKER, BRANDY (RN)
Entity type:Individual
Prefix:
First Name:BRANDY
Middle Name:
Last Name:BAKER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 STATE HIGHWAY 16 S
Mailing Address - Street 2:
Mailing Address - City:GRAHAM
Mailing Address - State:TX
Mailing Address - Zip Code:76450-3835
Mailing Address - Country:US
Mailing Address - Phone:940-282-2512
Mailing Address - Fax:940-521-9139
Practice Address - Street 1:1005 STATE HIGHWAY 16 S
Practice Address - Street 2:
Practice Address - City:GRAHAM
Practice Address - State:TX
Practice Address - Zip Code:76450-3835
Practice Address - Country:US
Practice Address - Phone:940-282-2512
Practice Address - Fax:940-521-9139
Is Sole Proprietor?:No
Enumeration Date:2024-12-23
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX1188814363LF0000X
TX900748163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse