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General NPI Number Information
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NPI Number | 1730155250
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Entity Type | Individual
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Provider Name | ANDREA M BAYLISS CRNA
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Gender | Female
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Dates
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Enumeration Date | 02/24/2006
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Last Update Date | 12/11/2024
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Provider Practice Location Address
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Address Line | 3535 SOUTHERN BVLD
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City | KETTERING
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State | OH
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Zip | 45429
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Country | US
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Telephone | 937-293-8228
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Fax | 937-293-8229
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Provider Business Mailing Address
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Address Line | 3533 SOUTHERN BLVD SUITE 3100
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City | KETTERING
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State | OH
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Zip | 45429-1264
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Country | US
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Telephone | 937-293-8228
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Fax | 937-293-8229
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | APN.0991232-CRNA
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | RN-261227
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License Number State | OH
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