Selena Lauren Baker, RDN, LD

Individual provider Active NPI Registered Dietitian · Lafayette, IN

NPI 1336724541 · NPPES record last updated Mar 10, 2021

Key facts

NPI
1336724541
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
37003070A (IN)
Practice address
5165 McCarty LN
Lafayette, IN 47905-8764
Phone
(765) 838-7493
NPI assigned
Mar 10, 2021
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
37003070AINMDRegistered Dietitian

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 37003070A IN Yes

Addresses

Primary practice location

5165 McCarty LN
Lafayette, IN 47905-8764

Mailing address

1808 Perrine St
Lafayette, IN 47904-1446
Phone (765) 337-2093

Other identifiers

IdentifierTypeStateIssuer
37003070AOtherININDIANA PROFESSIONAL LICENSING AGENCY MEDICAL LICENSING BOARD OF INDIANA
984074OtherCOMMISSION ON DIETETIC REGISTRATION

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address sbaker29@iuhealth.org Direct

Other providers in Lafayette, IN

All providers in Lafayette, IN · Registered Dietitian in Indiana

Sources for this page

Verify at the official NPI Registry.