Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VX0000X | Obstetrician | 45652 | MN |
Y | 207VX0201X | Gynecologic Oncologist | 45652 | MN |
N | 207VX0201X | Gynecologic Oncologist | 57534 | WI |
NPI | 1245204114 |
---|---|
Provider Name | Jamie N Bakkum-Gamez |
First Address | Rochester, MN 55905-0001 |
Second Address | Rochester, MN 55905-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2006 |
Last Update Date | 12/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H88659 | (02) |