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General NPI Number Information
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NPI Number | 1558806901
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Entity Type | Organization
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Legal Business Name | CHRISTINE BAILES, LLC
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Dates
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Enumeration Date | 12/21/2016
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Last Update Date | 09/13/2023
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Provider Practice Location Address
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Address Line | 3505 E MERIDIAN PARK LOOP STE 100
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City | WASILLA
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State | AK
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Zip | 99654-7242
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Country | US
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Telephone | 907-864-0022
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Fax | 877-725-7371
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Provider Business Mailing Address
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Address Line | 3505 E MERIDIAN PARK LOOP STE 100
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City | WASILLA
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State | AK
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Zip | 99654-7242
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Country | US
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Telephone | 907-864-0022
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Fax | 877-725-7371
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Authorized Official
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Title or Position | ANP / OWNER
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Name | CHRISTINE OLGA BAILES
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Credential |
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Telephone | 907-864-0022
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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