Provider Demographics
NPI:1225764285
Name:BAKER, SHERRY MONTELIUS (APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:MONTELIUS
Last Name:BAKER
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1303 TOWN CENTER PKWY UNIT 10203
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-8090
Mailing Address - Country:US
Mailing Address - Phone:504-512-6721
Mailing Address - Fax:
Practice Address - Street 1:4201 WOODLAND DR
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70131-7339
Practice Address - Country:US
Practice Address - Phone:504-446-1111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-30
Last Update Date:2022-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA226974363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily