Provider Demographics
NPI:1699215814
Name:BAKER, LESHANTA
Entity Type:Individual
Prefix:
First Name:LESHANTA
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 1:3329 E BAYAUD AVE APT 804
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209-3372
Mailing Address - Country:US
Mailing Address - Phone:850-443-4453
Mailing Address - Fax:
Practice Address - Street 1:3329 E BAYAUD AVE APT 804
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209-3372
Practice Address - Country:US
Practice Address - Phone:850-443-4453
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-07
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN 9267638163W00000X, 163WH0200X, 163WM0102X, 163WP1700X
FL13285374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn
No163WP1700XNursing Service ProvidersRegistered NursePerinatal
No374J00000XNursing Service Related ProvidersDoula