Provider Demographics
NPI:1679025563
Name:BAILEY, STEPHANIE MICHELLE (ND)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:MICHELLE
Last Name:BAILEY
Suffix:
Gender:F
Credentials:ND
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 31145
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85046-1145
Mailing Address - Country:US
Mailing Address - Phone:928-224-9437
Mailing Address - Fax:928-852-2017
Practice Address - Street 1:2756 W SR 89A
Practice Address - Street 2:
Practice Address - City:SEDONA
Practice Address - State:AZ
Practice Address - Zip Code:86336-5241
Practice Address - Country:US
Practice Address - Phone:928-224-9437
Practice Address - Fax:928-852-2017
Is Sole Proprietor?:No
Enumeration Date:2016-10-26
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ16-1599175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath