Healthcare Provider Details

I. General information

NPI: 1235065582
Provider Name (Legal Business Name): LAKERA BAYLOR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2718 WEST NORTH AVE 222
BALTIMORE MD
21216
US

IV. Provider business mailing address

PO BOX 1191
OWINGS MILLS MD
21117-1123
US

V. Phone/Fax

Practice location:
  • Phone: 667-513-4671
  • Fax:
Mailing address:
  • Phone: 667-513-4671
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246QL0900X
TaxonomyLaboratory Management Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: