Healthcare Provider Details

I. General information

NPI: 1932183316
Provider Name (Legal Business Name): DEBRA K. BAILEY FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/30/2005
Last Update Date: 10/12/2023
Certification Date: 10/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

195 STAFFORD LN
DELTA CO
81416-2229
US

IV. Provider business mailing address

2754 COMPASS DR STE 377
GRAND JUNCTION CO
81506-8723
US

V. Phone/Fax

Practice location:
  • Phone: 970-874-6823
  • Fax: 970-874-6903
Mailing address:
  • Phone: 970-241-2212
  • Fax: 970-257-2401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN.0001463-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: