Provider Demographics
NPI:1497119333
Name:BAILEY-MARTIN, LISA V
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:V
Last Name:BAILEY-MARTIN
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 1:5742 S ADDISON WAY UNIT C
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80016-4204
Mailing Address - Country:US
Mailing Address - Phone:303-881-0446
Mailing Address - Fax:
Practice Address - Street 1:5742 S ADDISON WAY UNIT C
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80016-4204
Practice Address - Country:US
Practice Address - Phone:303-881-0446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-06
Last Update Date:2016-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health