Provider Demographics
NPI:1053623462
Name:BAILEY, NATALYA MARIE (BSN, RN)
Entity type:Individual
Prefix:MRS
First Name:NATALYA
Middle Name:MARIE
Last Name:BAILEY
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 453
Mailing Address - Street 2:
Mailing Address - City:KLAWOCK
Mailing Address - State:AK
Mailing Address - Zip Code:99925-0453
Mailing Address - Country:US
Mailing Address - Phone:907-401-3138
Mailing Address - Fax:
Practice Address - Street 1:6341 E STREET
Practice Address - Street 2:
Practice Address - City:KLAWOCK
Practice Address - State:AK
Practice Address - Zip Code:99925-0453
Practice Address - Country:US
Practice Address - Phone:907-401-3138
Practice Address - Fax:907-755-4981
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-14
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT331089-3102163W00000X, 163WG0000X
AK53100163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice