Provider Demographics
NPI:1083381610
Name:KULISH, BAILEE MAE (BS)
Entity Type:Individual
Prefix:MS
First Name:BAILEE
Middle Name:MAE
Last Name:KULISH
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8461 TURNPIKE DR STE 102
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80031-4378
Mailing Address - Country:US
Mailing Address - Phone:720-515-4244
Mailing Address - Fax:720-441-0448
Practice Address - Street 1:8461 TURNPIKE DR STE 102
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031-4378
Practice Address - Country:US
Practice Address - Phone:720-515-4244
Practice Address - Fax:720-441-0448
Is Sole Proprietor?:No
Enumeration Date:2021-08-23
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program