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General NPI Number Information
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NPI Number | 1750665576
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Entity Type | Individual
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Provider Name | TAMMY LYNN BAKER PA-C
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Gender | Female
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Dates
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Enumeration Date | 09/29/2011
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Last Update Date | 11/21/2025
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Provider Practice Location Address
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Address Line | 501 STATE ST N
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City | WASECA
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State | MN
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Zip | 56093-2811
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Country | US
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Telephone | 507-835-1210
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Fax |
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Provider Business Mailing Address
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Address Line | 1025 MARSH ST
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City | MANKATO
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State | MN
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Zip | 56001-4752
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Country | US
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Telephone | 507-625-4031
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Fax |
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 10996
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 10996
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License Number State | MN
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