MANISA PHOPHAIRAT BAKER Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

FULL PRACTICE AUTHORITY APRN

License Number

277002006

License Status

ACTIVE

Business

First Name

MANISA

Middle

PHOPHAIRAT

Last Name

BAKER

Business Name

MANISA PHOPHAIRAT BAKER

Original Issue Date

06/06/2022

Effective Date

03/25/2024

Expiration Date

05/31/2026

City

SAINT JOHN

State

Zip

46373

County

INDIANA

Ever Disciplined

LastModifiedDate

03/02/2026