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General NPI Number Information
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NPI Number | 1700648698
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Entity Type | Individual
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Provider Name | AUGUST MANESHA BAKER APRN
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Gender | Female
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Dates
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Enumeration Date | 01/25/2024
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Last Update Date | 11/17/2025
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Provider Practice Location Address
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Address Line | 1229 AR HIGHWAY 77 UNIT#1
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City | MARION
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State | AR
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Zip | 72364
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Country | US
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Telephone | 870-400-7775
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Fax |
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Provider Business Mailing Address
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Address Line | 250 BLAIR DR
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City | MARION
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State | AR
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Zip | 72364-2617
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Country | US
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Telephone | 901-849-3039
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 226548
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License Number State | AR
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