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General NPI Number Information
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NPI Number | 1457827297
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Entity Type | Individual
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Provider Name | LAUREN ELISE BAILEY PA
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Gender | Female
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Dates
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Enumeration Date | 10/19/2018
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Last Update Date | 10/19/2018
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Provider Practice Location Address
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Address Line | 1219 NATIONAL HWY
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City | LAVALE
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State | MD
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Zip | 21502-7602
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Country | US
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Telephone | 301-729-0529
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Fax |
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Provider Business Mailing Address
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Address Line | 4018 CHELSTEAD WAY
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City | MURRYSVILLE
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State | PA
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Zip | 15668-1762
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Country | US
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Telephone | 724-516-4479
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | C0007004
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License Number State | MD
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