Healthcare Provider Details

I. General information

NPI: 1568873206
Provider Name (Legal Business Name): MELISSA G BAKKER DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MELISSA G HUNTON

II. Dates (important events)

Enumeration Date: 05/15/2014
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 JOHN DEERE RD
MOLINE IL
61265-6892
US

IV. Provider business mailing address

904 DILLON GRIBBLE RD
SPARTA TN
38583-6420
US

V. Phone/Fax

Practice location:
  • Phone: 308-779-5000
  • Fax:
Mailing address:
  • Phone: 404-441-2307
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number28301482
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number101270
License Number StateNE
# 3
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number4038604
License Number StateKY
# 4
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number225992
License Number StateAZ
# 5
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number209-026749
License Number StateIL
# 6
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number43-557677-121
License Number StateKS
# 7
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number26968
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: