Individual
MS. MADISON MCKENZIE BAKKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-5450
(336) 713-8250
(336) 713-8252
Mailing address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 713-8250
(336) 713-8252
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5015099
NC
363LF0000X
Family Nurse Practitioner
BAKK-N6SJJ
NC
363LF0000X
Family Nurse Practitioner
RN2381719
MA
Other
Enumeration date
09/22/2021
Last updated
08/29/2024
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