Healthcare Provider Details

I. General information

NPI: 1821987660
Provider Name (Legal Business Name): MICHELLE T BAILEY FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2025
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29610 RANCHO CALIFORNIA RD
TEMECULA CA
92591-5283
US

IV. Provider business mailing address

491 MEADOWOOD ST
FALLBROOK CA
92028-6575
US

V. Phone/Fax

Practice location:
  • Phone: 951-699-0192
  • Fax:
Mailing address:
  • Phone: 619-654-8404
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95034794
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: