Provider Demographics
NPI:1295382331
Name:BAKER, LINDSEY C
Entity Type:Individual
Prefix:MISS
First Name:LINDSEY
Middle Name:C
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:PO BOX 871524
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99687-1524
Mailing Address - Country:US
Mailing Address - Phone:907-841-2077
Mailing Address - Fax:888-588-5194
Practice Address - Street 1:21659A SONGBIRD DR
Practice Address - Street 2:
Practice Address - City:CHUGIAK
Practice Address - State:AK
Practice Address - Zip Code:99567-5615
Practice Address - Country:US
Practice Address - Phone:907-373-1000
Practice Address - Fax:888-588-5194
Is Sole Proprietor?:No
Enumeration Date:2019-08-22
Last Update Date:2019-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK000000171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator