Individual
HEATHER BAKKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
524 W CENTRE AVE, PORTAGE, MI 49024-5306
(269) 324-1180
Mailing address
11159 RED ARROW HWY, BRIDGMAN, MI 49106-9797
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704217120
MI
Other
Enumeration date
07/31/2018
Last updated
07/31/2018
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