Provider Demographics
NPI:1225635055
Name:BAIG, MARY FRANCES FLAHERTY (APRN, FNP)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:FRANCES FLAHERTY
Last Name:BAIG
Suffix:
Gender:F
Credentials:APRN, FNP
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:FRANCES
Other - Last Name:FLAHERTY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:104 SUMMIT AVE
Mailing Address - Street 2:
Mailing Address - City:CENTER CITY
Mailing Address - State:MN
Mailing Address - Zip Code:55012-9647
Mailing Address - Country:US
Mailing Address - Phone:701-340-8735
Mailing Address - Fax:
Practice Address - Street 1:257 W SAINT GEORGE AVE
Practice Address - Street 2:
Practice Address - City:GRANTSBURG
Practice Address - State:WI
Practice Address - Zip Code:54840-7827
Practice Address - Country:US
Practice Address - Phone:800-293-5353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-05
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10418-33363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily