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General NPI Number Information
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NPI Number | 1376219097
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Entity Type | Individual
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Provider Name | BAYLEE GORGES PHARMD
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Gender | Female
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Dates
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Enumeration Date | 08/22/2021
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Last Update Date | 06/13/2024
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Provider Practice Location Address
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Address Line | 333 N GREEN BAY RD
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City | NEENAH
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State | WI
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Zip | 54956-1954
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Country | US
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Telephone | 920-729-6088
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Fax |
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Provider Business Mailing Address
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Address Line | 3 NEENAH CTR
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City | NEENAH
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State | WI
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Zip | 54956-3070
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Country | US
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Telephone | 920-729-6088
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PENDING
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 5302413678
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 1835P2201X
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Taxonomy Name | Ambulatory Care Pharmacist
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License Number | 21022
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License Number State | WI
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Taxonomy #4
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Taxonomy Code | 1835P2201X
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Taxonomy Name | Ambulatory Care Pharmacist
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License Number | 5302413678
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License Number State | MI
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Taxonomy #5
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Taxonomy Code | 1835P2201X
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Taxonomy Name | Ambulatory Care Pharmacist
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License Number | PENDING
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License Number State | MI
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Taxonomy #6
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 21022
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License Number State | WI
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