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Individual

MS. TESHA LANATTE BAKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
610 S 2ND ST, DES ARC, AR 72040-3034
(870) 256-5669
Mailing address
610 S 2ND ST, DES ARC, AR 72040-3034
(870) 256-5669

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L056480
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
L056480
STATE BOARD OF NURSING
AR
Enumeration date
09/30/2021
Last updated
09/30/2021
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