Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213ES0103X | Foot & Ankle Surgery | PO3416 | FL |
Y | 213ES0131X | Foot Surgery | 610 | SC |
NPI | 1063665636 |
---|---|
Provider Name | Dr. Jordanna Lynn Baker |
First Address | Florence, SC 29501-4075 |
Second Address | Florence, SC 29501-4075 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/10/2008 |
Last Update Date | 01/09/2021 |