Provider Demographics
NPI:1346804788
Name:BAKER, LAKYN ASHLEIGH (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LAKYN
Middle Name:ASHLEIGH
Last Name:BAKER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2491 HIGHWAY 120
Mailing Address - Street 2:
Mailing Address - City:ROBELINE
Mailing Address - State:LA
Mailing Address - Zip Code:71469-5509
Mailing Address - Country:US
Mailing Address - Phone:318-609-2101
Mailing Address - Fax:
Practice Address - Street 1:1585 3RD ST
Practice Address - Street 2:
Practice Address - City:FORT POLK
Practice Address - State:LA
Practice Address - Zip Code:71459-5102
Practice Address - Country:US
Practice Address - Phone:318-609-2101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-30
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA021386183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2552015Medicaid