MEDICARE: MRS. SYLVIA ANNE BAILEY-ALLEN RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WC1500X	Community Health Registered Nurse		OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194805119
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SYLVIA ANNE BAILEY-ALLEN RN

Provider Business Mailing Address
First Line	:	92618 KNUTSON LN
Second Line	:
City	:	COOS BAY
State	:	OR
Zip	:	97420-8485
Country	:	US
Telephone Number	:	541-267-4644
Fax Number	:	541-267-4644

Provider Business Practice Location Address
First Line	:	92618 KNUTSON LN
Second Line	:
City	:	COOS BAY
State	:	OR
Zip	:	97420-8485
Country	:	US
Telephone Number	:	541-267-4644
Fax Number	:	541-267-4644

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/16/2006
Last Update Date	:	07/09/2007

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