Healthcare Provider Details

I. General information

NPI: 1659287811
Provider Name (Legal Business Name): DALA BAKER LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6330 HIGHWAY 71 S
COVE AR
71937-9693
US

IV. Provider business mailing address

170 POLK ROAD 18
COVE AR
71937-9502
US

V. Phone/Fax

Practice location:
  • Phone: 870-387-4200
  • Fax: 870-387-2058
Mailing address:
  • Phone: 870-387-4200
  • Fax: 870-387-2058

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberL055787
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: