Healthcare Provider Details

I. General information

NPI: 1760677223
Provider Name (Legal Business Name): GABRIELLE ANN BAYS AGPCNP-BC, RN-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2007
Last Update Date: 08/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 MARION AVE
BIG RAPIDS MI
49307-1300
US

IV. Provider business mailing address

505 MARION AVE
BIG RAPIDS MI
49307-1300
US

V. Phone/Fax

Practice location:
  • Phone: 858-336-6932
  • Fax:
Mailing address:
  • Phone: 858-336-6932
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number212612
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number212612
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number212612
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number4704335112
License Number StateMI
# 5
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number4704335112
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: