MEDICARE: DEVIN BAILEY 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	163W00000X	Registered Nurse	257394	WI

General Provider Information

NPI Number	:	1982295267
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEVIN BAILEY RN

Provider Business Mailing Address
First Line	:	2947 S 71ST ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53219-2954
Country	:	US
Telephone Number	:	414-690-6923
Fax Number	:

Provider Business Practice Location Address
First Line	:	2947 S 71ST ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53219-2954
Country	:	US
Telephone Number	:	414-690-6923
Fax Number	:

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

Provider Enumeration Date	:	01/29/2021
Last Update Date	:	01/29/2021

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Directions to “ DEVIN BAILEY RN” Practice Location

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