Provider Demographics
NPI:1912389503
Name:BAKER, LISA JONES (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:JONES
Last Name:BAKER
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1002 HIGHLAND AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71101-4143
Mailing Address - Country:US
Mailing Address - Phone:318-678-7500
Mailing Address - Fax:318-222-6227
Practice Address - Street 1:1002 HIGHLAND AVE FL 2
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71101-4143
Practice Address - Country:US
Practice Address - Phone:318-678-7500
Practice Address - Fax:318-222-6227
Is Sole Proprietor?:No
Enumeration Date:2015-06-19
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP08366363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health