| Lisa Baxter | |
|
974 73rd St Ste 24 Windsor Heights IA 50324-1200 | |
| (515) 267-9054 | |
| (515) 267-9057 |
| Full Name | Lisa Baxter |
|---|---|
| Speciality | Social Worker |
| Location | 974 73rd St Ste 24, Windsor Heights, Iowa |
| Authorized Official Name and Position | Lisa Baxter (CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 5152679057 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lisa Baxter 974 73rd St Ste 24 Windsor Heights IA 50324-1200 Ph: (515) 267-9054 | Lisa Baxter 974 73rd St Ste 24 Windsor Heights IA 50324-1200 Ph: (515) 267-9054 |
| NPI Number | 1336648088 |
|---|---|
| Provider Enumeration Date | 02/08/2018 |
| Last Update Date | 02/08/2018 |
| Medicare PECOS PAC ID | 5890056915 |
|---|---|
| Medicare Enrollment ID | O20180305002362 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336648088 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Lisa M Baxter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790882884 PECOS PAC ID: 7517986375 Enrollment ID: I20051122000349 |
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