Provider Demographics
NPI:1386002731
Name:BAKER, JAMIE LEE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:LEE
Last Name:BAKER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:JAMIE
Other - Middle Name:LEE
Other - Last Name:GUNNARSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:204 LUNDORFF DR
Mailing Address - Street 2:
Mailing Address - City:SANDSTONE
Mailing Address - State:MN
Mailing Address - Zip Code:55072-5051
Mailing Address - Country:US
Mailing Address - Phone:320-245-5500
Mailing Address - Fax:
Practice Address - Street 1:204 LUNDORFF DR
Practice Address - Street 2:
Practice Address - City:SANDSTONE
Practice Address - State:MN
Practice Address - Zip Code:55072-5051
Practice Address - Country:US
Practice Address - Phone:320-245-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-31
Last Update Date:2016-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN122432183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist