Provider Demographics
NPI:1942173216
Name:BAKER, RENA
Entity type:Individual
Prefix:
First Name:RENA
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 1:18295 LINDSAY ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48235-3243
Mailing Address - Country:US
Mailing Address - Phone:888-717-2102
Mailing Address - Fax:833-740-4255
Practice Address - Street 1:33150 SCHOOLCRAFT RD STE L4
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48150-1631
Practice Address - Country:US
Practice Address - Phone:888-717-2102
Practice Address - Fax:833-740-4255
Is Sole Proprietor?:No
Enumeration Date:2025-09-24
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No374U00000XNursing Service Related ProvidersHome Health Aide