| NPI | 1144529496 | 
|---|---|
| Former Name | SHANNON LEIGH BAKER | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 12417) | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0005843) | 
| 363A00000X Physician Assistant (Licence: NH 0838) | |
| Enumeration Date | 2011-03-24 | 
| Last Update Date | 2025-10-28 |