Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | DEM-LD-10156108 | OR |
NPI | 1114365889 |
---|---|
Provider Name | Julia May Bailey |
First Address | Albany, OR 97322-5211 |
Second Address | Albany, OR 97322-5293 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2013 |
Last Update Date | 04/06/2013 |