Provider Demographics
NPI:1801503677
Name:BAAH, LYDIA SIAW
Entity type:Individual
Prefix:
First Name:LYDIA
Middle Name:SIAW
Last Name:BAAH
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 1:3033 W DIVIDE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83646-5665
Mailing Address - Country:US
Mailing Address - Phone:720-345-7186
Mailing Address - Fax:
Practice Address - Street 1:3033 W DIVIDE CREEK DR
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83646-5665
Practice Address - Country:US
Practice Address - Phone:720-345-7186
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-01
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide