Individual
REBECCA JO BAKKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2701 13TH AVE S, FARGO, ND 58103-3602
(701) 234-3620
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
11565
ND
208000000X
Pediatrics Physician
51.013675
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
15288
—
ND
Enumeration date
08/04/2008
Last updated
03/25/2022
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