Individual
GEORGIA M. BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
7925 YOUREE DR, SUITE 200, SHREVEPORT, LA 71105-5127
(318) 212-3610
(318) 212-3709
Mailing address
7925 YOUREE DR, SUITE 200, SHREVEPORT, LA 71105-5127
(318) 212-3610
(318) 212-3709
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP05611
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3A840CR96
MEDICARE PTAN
LA
Enumeration date
09/24/2008
Last updated
01/23/2014
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