Healthcare Provider Details

I. General information

NPI: 1689102477
Provider Name (Legal Business Name): MARGARET BAKER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/24/2017
Last Update Date: 01/22/2026
Certification Date: 01/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3674 S WASHINGTON ST
GRAND FORKS ND
58201-5766
US

IV. Provider business mailing address

PO BOX 5210
GRAND FORKS ND
58206-5210
US

V. Phone/Fax

Practice location:
  • Phone: 701-205-3000
  • Fax: 701-732-2501
Mailing address:
  • Phone: 701-205-3000
  • Fax: 701-732-2501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number345865
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: