Healthcare Provider Details

I. General information

NPI: 1619452448
Provider Name (Legal Business Name): SARAH ELIZABETH BAKER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARA E DOSS NP

II. Dates (important events)

Enumeration Date: 09/27/2018
Last Update Date: 09/25/2020
Certification Date: 09/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12120 COLONEL GLENN RD STE 10000
LITTLE ROCK AR
72210-2849
US

IV. Provider business mailing address

12120 COLONEL GLENN RD STE 10000
LITTLE ROCK AR
72210-2849
US

V. Phone/Fax

Practice location:
  • Phone: 337-991-9276
  • Fax: 337-943-0846
Mailing address:
  • Phone: 337-991-5927
  • Fax: 337-943-0846

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberA005508
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code364SA2100X
TaxonomyAcute Care Clinical Nurse Specialist
License NumberA005508
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: