Provider Demographics
NPI:1831306729
Name:BAKER, SHUNDREA L
Entity Type:Individual
Prefix:MS
First Name:SHUNDREA
Middle Name:L
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 1:1207 W SCENIC DR
Mailing Address - Street 2:APT. R25
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72118-3335
Mailing Address - Country:US
Mailing Address - Phone:501-563-2892
Mailing Address - Fax:
Practice Address - Street 1:1207 W SCENIC DR
Practice Address - Street 2:APT. R25
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72118-3335
Practice Address - Country:US
Practice Address - Phone:501-563-2892
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist