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General NPI Number Information
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NPI Number | 1003743857
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Entity Type | Organization
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Legal Business Name | BRENDA BAKER PAC LLC
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Dates
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Enumeration Date | 05/06/2026
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Last Update Date | 05/06/2026
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Provider Practice Location Address
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Address Line | 330 S 2ND ST STE 200-1538
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City | MINNEAPOLIS
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State | MN
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Zip | 55401-2513
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Country | US
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Telephone | 612-876-2775
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Fax | 612-808-1815
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Provider Business Mailing Address
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Address Line | 330 S 2ND ST STE 200-1538
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City | MINNEAPOLIS
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State | MN
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Zip | 55401-2513
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Country | US
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Telephone | 612-876-2775
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Fax | 612-808-1815
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Authorized Official
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Title or Position | OWNER
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Name | BRENDA JOY BAKER
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Credential | PAC
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Telephone | 952-200-5238
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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