Individual
EVELYN E BAKKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1025 MARSH ST, MANKATO, MN 56001-4752
(507) 345-2623
Mailing address
508 POINT AVE, MADISON LAKE, MN 56063-9632
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R056714-5
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
115407
UCARE
—
01
—
15863BA
BLUE CROSS BLUE SHIELD MN
—
01
—
2000848
MEDICA
—
01
—
967551028142
PREFERRED ONE
—
01
—
HP57705
HEALTH PARTNERS
—
Enumeration date
10/16/2007
Last updated
11/20/2007
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