Provider Demographics
NPI:1083656904
Name:BAKER, LYNDA M (CRNA)
Entity Type:Individual
Prefix:MS
First Name:LYNDA
Middle Name:M
Last Name:BAKER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1206 TUNLAW RD SE
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-2513
Mailing Address - Country:US
Mailing Address - Phone:256-539-0922
Mailing Address - Fax:205-979-1248
Practice Address - Street 1:1206 TUNLAW RD SE
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-2513
Practice Address - Country:US
Practice Address - Phone:256-539-0922
Practice Address - Fax:205-979-1248
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-12
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-063448367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL515-02332OtherBCBS
AL515-30481OtherBLUE CROSS BLUE SHIELD
AL515-42861OtherBCBS
AL515-30481OtherBLUE CROSS BLUE SHIELD
ALP00248674Medicare PIN