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General NPI Number Information
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NPI Number | 1770592412
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Entity Type | Individual
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Provider Name | STEPHANIE BAKKER NP
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Gender | Female
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 12/23/2024
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Provider Practice Location Address
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Address Line | 1815 S CLINTON AVE
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City | ROCHESTER
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State | NY
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Zip | 14618-5720
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Country | US
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Telephone | 585-305-7934
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Fax | 585-287-5548
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Provider Business Mailing Address
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Address Line | 515 LICIA LN
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City | WEBSTER
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State | NY
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Zip | 14580-8750
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Country | US
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Telephone | 585-747-6310
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Fax | 585-672-1373
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F334397
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License Number State | NY
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