MEDICARE: MS. LEIGH CORTNY BAKER BSN, RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program	RN	AZ

General Provider Information

NPI Number	:	1578402293
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LEIGH CORTNY BAKER BSN, RN

Provider Business Mailing Address
First Line	:	630 SAND DAB DR
Second Line	:
City	:	LAKE HAVASU CITY
State	:	AZ
Zip	:	86404-2721
Country	:	US
Telephone Number	:	928-412-5209
Fax Number	:	928-412-5209

Provider Business Practice Location Address
First Line	:	630 SAND DAB DR
Second Line	:
City	:	LAKE HAVASU CITY
State	:	AZ
Zip	:	86404-2721
Country	:	US
Telephone Number	:	928-412-5209
Fax Number	:	928-412-5209

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/27/2026
Last Update Date	:	03/27/2026

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