Provider Demographics
NPI:1861795817
Name:BAKER, ELIZABETH I (RPH)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:I
Last Name:BAKER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6300 CREEDMOOR RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-6730
Mailing Address - Country:US
Mailing Address - Phone:919-870-6030
Mailing Address - Fax:919-870-7908
Practice Address - Street 1:6300 CREEDMOOR RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-6730
Practice Address - Country:US
Practice Address - Phone:919-870-6030
Practice Address - Fax:919-870-7908
Is Sole Proprietor?:No
Enumeration Date:2010-12-14
Last Update Date:2016-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13062183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist