Healthcare Provider Details

I. General information

NPI: 1053078907
Provider Name (Legal Business Name): MAKAYA RHEA BAKER APRN-CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/25/2021
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 N MAIN ST # 2
HARRISON AR
72601-2953
US

IV. Provider business mailing address

620 N MAIN ST # 2
HARRISON AR
72601-2953
US

V. Phone/Fax

Practice location:
  • Phone: 870-414-4000
  • Fax: 870-414-4949
Mailing address:
  • Phone: 870-414-4000
  • Fax: 870-414-4949

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number217693
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: