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Individual

KANIKA LANESE BAKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
7240 BROOKLYN BLVD STE 150, BROOKLYN PARK, MN 55429-1274
(888) 507-6235
Mailing address
12526 74TH AVE N, MAPLE GROVE, MN 55369-5290
(612) 458-7857

Taxonomy

Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
18438613
MN

Other

Enumeration date
11/05/2020
Last updated
11/05/2020
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