Provider Demographics
NPI:1053819490
Name:FINCH, BAILEY JANE
Entity Type:Individual
Prefix:
First Name:BAILEY
Middle Name:JANE
Last Name:FINCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9861 NEAPOLIS WATERVILLE RD
Mailing Address - Street 2:
Mailing Address - City:WATERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43566
Mailing Address - Country:US
Mailing Address - Phone:567-686-5358
Mailing Address - Fax:
Practice Address - Street 1:9861 NEAPOLIS WATERVILLE RD
Practice Address - Street 2:
Practice Address - City:WATERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43566
Practice Address - Country:US
Practice Address - Phone:419-878-7106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-31
Last Update Date:2018-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHJWQ524M56M180OtherANTHEM BLUE CROSS BLUE SHIELD