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General NPI Number Information
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NPI Number | 1023364379
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Entity Type | Individual
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Provider Name | REBECCA B BAKKER RPH
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Gender | Female
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Dates
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Enumeration Date | 07/24/2012
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Last Update Date | 07/24/2012
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Provider Practice Location Address
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Address Line | 522 MAIN ST W
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City | ASHLAND
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State | WI
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Zip | 54806-1512
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Country | US
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Telephone | 715-682-3123
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Fax | 715-682-6494
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Provider Business Mailing Address
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Address Line | 522 MAIN ST W
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City | ASHLAND
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State | WI
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Zip | 54806-1512
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Country | US
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Telephone | 715-682-3123
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Fax | 715-682-6494
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 114371
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 1430140
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License Number State | WI
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