Provider Demographics
NPI:1093026528
Name:BAKKE, RHONDA IRENE (NP)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:IRENE
Last Name:BAKKE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:RHONDA
Other - Middle Name:IRENE
Other - Last Name:TADROS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:2020 E 28TH ST
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407-1394
Mailing Address - Country:US
Mailing Address - Phone:612-333-0770
Mailing Address - Fax:
Practice Address - Street 1:2020 E 28TH ST
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55407-1394
Practice Address - Country:US
Practice Address - Phone:612-333-0770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-30
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR1486144363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily