Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0205X | Pediatric Endocrinologist | 19012 | MT |
Y | 2080P0205X | Pediatric Endocrinologist | 5812 | AK |
N | 2080P0205X | Pediatric Endocrinologist | G56672 | CA |
NPI | 1023117033 |
---|---|
Provider Name | Wendy Bailey |
First Address | Anchorage, AK 99508-4691 |
Second Address | Anchorage, AK 99508-4691 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2006 |
Last Update Date | 24/07/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6946 | (05) | AK |