Individual
SARA M BAKKEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
718 JUPITER DR, MADISON, WI 53718-2950
(608) 663-8706
(608) 251-2868
Mailing address
718 JUPITER DR, MADISON, WI 53718-2950
(608) 663-8706
(608) 251-2868
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
5541-024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40281600
—
WI
Enumeration date
04/08/2008
Last updated
04/08/2008
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