Provider Demographics
NPI:1780214395
Name:BAKER, LINDSEY JO (MS RDN)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:JO
Last Name:BAKER
Suffix:
Gender:F
Credentials:MS RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8204 E ARCTIC WILLOW CIR
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57110-7000
Mailing Address - Country:US
Mailing Address - Phone:605-413-2451
Mailing Address - Fax:
Practice Address - Street 1:8204 E ARCTIC WILLOW CIR
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57110-7000
Practice Address - Country:US
Practice Address - Phone:605-413-2451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-22
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD0653133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered