Provider Demographics
NPI:1487031050
Name:BAILEY, JUNE A (LPN)
Entity Type:Individual
Prefix:MRS
First Name:JUNE
Middle Name:A
Last Name:BAILEY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:COHOCTON
Mailing Address - State:NY
Mailing Address - Zip Code:14826-9707
Mailing Address - Country:US
Mailing Address - Phone:585-384-5425
Mailing Address - Fax:585-384-5425
Practice Address - Street 1:65 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:COHOCTON
Practice Address - State:NY
Practice Address - Zip Code:14826-9707
Practice Address - Country:US
Practice Address - Phone:585-384-5425
Practice Address - Fax:585-384-5425
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-01
Last Update Date:2015-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY249954-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse