Baker, Deidra Lynn

Baker, Deidra Lynn is an individual health care provider with primary practice located at 804 Medical Circle Suite G, Longview TX 75605. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Obstetrics & Gynecology, which is considered as her primary health care specialty. Baker, Deidra Lynn can be contacted via phone (903) 234-8030.

Contact Information

Primary practice address
804 Medical Circle Suite G Longview TX 75605
Phone: (903) 234-8030
Fax: (903) 234-8039
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Obstetrics & Gynecology 363LX0001X 06786 Texas

Profile Details

NPI number 1962508929
LBN Legal business name Baker, Deidra Lynn
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 16th, 2006
Last updated May 28th, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962508929 NPPES
Texas MEDICAID 184537201

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