Provider Demographics
NPI:1275267528
Name:FRASER, BAILEY MARIE (MSN, PMHNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:BAILEY
Middle Name:MARIE
Last Name:FRASER
Suffix:
Gender:F
Credentials:MSN, PMHNP-BC
Other - Prefix:MS
Other - First Name:BAILEY
Other - Middle Name:MARIE
Other - Last Name:BRADSHAW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSN, RN
Mailing Address - Street 1:2139 N 12TH ST STE 6
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81501-2910
Mailing Address - Country:US
Mailing Address - Phone:970-283-7153
Mailing Address - Fax:
Practice Address - Street 1:2139 N 12TH ST STE 6
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-2910
Practice Address - Country:US
Practice Address - Phone:970-283-7153
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-13
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0997713-NP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health