Tesha Lanatte Baker, LPN

Individual provider Active NPI Licensed Practical Nurse · Des Arc, AR

NPI 1871265645 · NPPES record last updated Sep 30, 2021

Key facts

NPI
1871265645
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
L056480 (AR)
Practice address
610 S 2ND St
Des Arc, AR 72040-3034
Phone
(870) 256-5669
NPI assigned
Sep 30, 2021
Sex
Female
Sole proprietor
Yes

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
L056480ARMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X L056480 AR Yes

Addresses

Primary practice location

610 S 2ND St
Des Arc, AR 72040-3034

Mailing address

610 S 2ND St
Des Arc, AR 72040-3034
Phone (870) 256-5669

Other identifiers

IdentifierTypeStateIssuer
L056480OtherARSTATE BOARD OF NURSING

Other providers in Des Arc, AR

All providers in Des Arc, AR · Licensed Practical Nurse in Arkansas

Sources for this page

Verify at the official NPI Registry.