Basic Information
| Provider Information | |||||||||
| NPI: | 1790145738 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BAKAN-FISCHER | ||||||||
| FirstName: | AYBIKE | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3518 NICOLLET AVE APT 207 | ||||||||
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| City: | MINNEAPOLIS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554084575 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7273646122 | ||||||||
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| Practice Location | |||||||||
| Address1: | 6405 FRANCE AVE S | ||||||||
| Address2: | |||||||||
| City: | EDINA | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554352163 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6123655000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/03/2016 | ||||||||
| LastUpdateDate: | 06/14/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 2445 | MN | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.