Provider Demographics
NPI:1881858157
Name:BAKER, MARGARET E (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:E
Last Name:BAKER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MARGARET
Other - Middle Name:E
Other - Last Name:VENTURA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1120 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:UNION GROVE
Mailing Address - State:WI
Mailing Address - Zip Code:53182-1328
Mailing Address - Country:US
Mailing Address - Phone:262-878-4424
Mailing Address - Fax:262-631-8591
Practice Address - Street 1:1120 MAIN ST
Practice Address - Street 2:
Practice Address - City:UNION GROVE
Practice Address - State:WI
Practice Address - Zip Code:53182-1328
Practice Address - Country:US
Practice Address - Phone:262-878-4424
Practice Address - Fax:262-631-8591
Is Sole Proprietor?:No
Enumeration Date:2008-07-15
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2300-023363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
11869047OtherCAQH
WI43020800Medicaid
WI43020800Medicaid
WI001132270Medicare PIN