Healthcare Provider Details

I. General information

NPI: 1982464384
Provider Name (Legal Business Name): BAYLI MANNS HIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2024
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1220 N EISENHOWER DR
BECKLEY WV
25801-3120
US

IV. Provider business mailing address

199 ELMER ST
PRINCETON WV
24740-2346
US

V. Phone/Fax

Practice location:
  • Phone: 681-222-6002
  • Fax:
Mailing address:
  • Phone: 304-487-1608
  • Fax: 304-521-4365

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number1657
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number1125
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: