MEDICARE: JOHNA LEA BAKER APRN, FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	53-80226-051	KS

General Provider Information

NPI Number	:	1093484321
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHNA LEA BAKER APRN, FNP-C

Provider Business Mailing Address
First Line	:	515 NORTHEAST SUMNER STREET
Second Line	:
City	:	TOPEKA
State	:	KS
Zip	:	66616
Country	:	US
Telephone Number	:	785-633-5574
Fax Number	:

Provider Business Practice Location Address
First Line	:	515 NORTHEAST SUMNER STREET
Second Line	:
City	:	TOPEKA
State	:	KS
Zip	:	66616
Country	:	US
Telephone Number	:	785-633-5574
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/09/2021
Last Update Date	:	09/09/2021

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