MEDICARE: BAILEY ELAINE HOLT AUD

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	231H00000X	Audiologist	AUD.0000995	CO

General Provider Information

NPI Number	:	1427576289
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BAILEY ELAINE HOLT AUD

Provider Business Mailing Address
First Line	:	9300 VALLEY CHILDRENS PL
Second Line	:
City	:	MADERA
State	:	CA
Zip	:	93636-8761
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1101 S YORK ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80210-1910
Country	:	US
Telephone Number	:	317-460-6781
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2017
Last Update Date	:	08/22/2024

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