Provider Demographics
NPI:1083128706
Name:GRANT-BAILEY, RUTH ELLEN (RN)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:ELLEN
Last Name:GRANT-BAILEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7365 LAWYER RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45244-3291
Mailing Address - Country:US
Mailing Address - Phone:513-233-3889
Mailing Address - Fax:
Practice Address - Street 1:7365 LAWYER RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45244-3291
Practice Address - Country:US
Practice Address - Phone:513-233-3889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-17
Last Update Date:2017-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH108610143199Medicaid