Provider Demographics
NPI:1508521428
Name:AVAESEN HEALTHCARE INC
Entity Type:Organization
Organization Name:AVAESEN HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FELICIA
Authorized Official - Middle Name:DALPHINE
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, MSN, FNP-C
Authorized Official - Phone:443-203-8681
Mailing Address - Street 1:5100 BUCKEYSTOWN PIKE STE 250
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21704-8344
Mailing Address - Country:US
Mailing Address - Phone:301-639-2936
Mailing Address - Fax:800-571-0474
Practice Address - Street 1:5100 BUCKEYSTOWN PIKE STE 250
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21704-8344
Practice Address - Country:US
Practice Address - Phone:443-692-7241
Practice Address - Fax:800-571-0474
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-04
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder