Provider Demographics
NPI:1497323752
Name:BAKER, LISA JANE
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:JANE
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 1:16392 SMITH HILL RD
Mailing Address - Street 2:
Mailing Address - City:NEWCOMERSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:43832-8902
Mailing Address - Country:US
Mailing Address - Phone:330-447-5364
Mailing Address - Fax:
Practice Address - Street 1:16392 SMITH HILL RD
Practice Address - Street 2:
Practice Address - City:NEWCOMERSTOWN
Practice Address - State:OH
Practice Address - Zip Code:43832-8902
Practice Address - Country:US
Practice Address - Phone:330-447-5364
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-14
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide