MEDICARE: BAILEY'S EARLY LEARNING HOME

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	305R00000X	Preferred Provider Organization

General Provider Information

NPI Number	:	1417612508
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAILEY'S EARLY LEARNING HOME

Provider Business Mailing Address
First Line	:	3862 N 38TH ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53216-3014
Country	:	US
Telephone Number	:	414-239-1497
Fax Number	:

Provider Business Practice Location Address
First Line	:	3862 N 38TH ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53216-3014
Country	:	US
Telephone Number	:	414-239-1497
Fax Number	:

Authorized Official
Title or Position	:	PRENATAL CARE COORDINATION
Name	:	BRIANA SHEREE VARNELL
Credential	:
Telephone Number	:	414-239-1497

Provider Enumeration Date	:	11/03/2021
Last Update Date	:	11/03/2021

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