Provider Demographics
NPI:1023357514
Name:BAILEY'S HEALTH CARE, INC.
Entity Type:Organization
Organization Name:BAILEY'S HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:CARPENTER
Authorized Official - Suffix:
Authorized Official - Credentials:DC, NP-C
Authorized Official - Phone:719-671-7386
Mailing Address - Street 1:141 W BLAKELAND DR
Mailing Address - Street 2:
Mailing Address - City:PUEBLO WEST
Mailing Address - State:CO
Mailing Address - Zip Code:81007-6339
Mailing Address - Country:US
Mailing Address - Phone:719-647-1043
Mailing Address - Fax:719-647-9287
Practice Address - Street 1:267 S JOE MARTINEZ BLVD
Practice Address - Street 2:
Practice Address - City:PUEBLO WEST
Practice Address - State:CO
Practice Address - Zip Code:81007-2741
Practice Address - Country:US
Practice Address - Phone:719-647-1043
Practice Address - Fax:719-647-9287
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-05
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3535111NN1001X
MO6069111NN1001X
CONP0990625363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC44543Medicare UPIN