Provider Demographics
NPI:1336673540
Name:BAKK, JULIANA MACHICAO (MD)
Entity type:Individual
Prefix:
First Name:JULIANA
Middle Name:MACHICAO
Last Name:BAKK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12200 W 106TH ST STE 125
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66215-2382
Mailing Address - Country:US
Mailing Address - Phone:913-599-1396
Mailing Address - Fax:
Practice Address - Street 1:12200 W 106TH ST STE 125
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66215-2382
Practice Address - Country:US
Practice Address - Phone:913-599-1396
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-13
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-49741207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology