NPI 1962266619 · live from the CMS NPI Registry
Ellie Anne Baker, PA-C
Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery in Fayetteville, AR. National Provider Identifier 1962266619, active.
NPI record
| NPI | 1962266619 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery 207WX0200X |
| Practice location | 158 E Sunbridge Dr, Fayetteville, AR 72703 |
| Practice phone | 479-222-0983 |
| Enumerated | February 12, 2024 |
| Last updated | June 10, 2024 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery primary | 207WX0200X | PT2024-014 (AR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.