Healthcare Provider Details

I. General information

NPI: 1245141076
Provider Name (Legal Business Name): LINDSEY MARIE BAKER PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2026
Last Update Date: 09/12/2026
Certification Date: 09/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 N SWALLOW TAIL DR STE 105
PORT ORANGE FL
32129-6103
US

IV. Provider business mailing address

3 WINDEMERE CT
EAST YORK PA
17402-4523
US

V. Phone/Fax

Practice location:
  • Phone: 561-223-1066
  • Fax:
Mailing address:
  • Phone: 614-595-5100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number11050098
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: