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Individual

JONA BAKKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
7600 FRANCE AVE S STE 4100, EDINA, MN 55435-6027
(952) 831-1551
(952) 831-0725
Mailing address
7600 FRANCE AVE S STE 4100, EDINA, MN 55435-6027
(952) 831-1551
(952) 831-0725

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
14200
MN
363AM0700X
Medical Physician Assistant
Primary
14200
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
14200
STATE LICENSE
MN
Enumeration date
09/14/2022
Last updated
11/09/2022
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