Provider Demographics
NPI:1518325836
Name:BAKER, DEVYN
Entity Type:Individual
Prefix:
First Name:DEVYN
Middle Name:
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 1:5229 COMMERCE
Mailing Address - Street 2:
Mailing Address - City:ST FRANCISVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70775
Mailing Address - Country:US
Mailing Address - Phone:225-245-5095
Mailing Address - Fax:
Practice Address - Street 1:5229 COMMERCE STREET
Practice Address - Street 2:
Practice Address - City:ST. FRANCISVILLE
Practice Address - State:LA
Practice Address - Zip Code:70775
Practice Address - Country:US
Practice Address - Phone:225-245-5095
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-01
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator