Provider Demographics
NPI:1629170089
Name:BAILEY, DEBORAH A (FNP)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:A
Last Name:BAILEY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 GENERAL MOTORS RD
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48381-2220
Mailing Address - Country:US
Mailing Address - Phone:248-889-1776
Mailing Address - Fax:248-684-7072
Practice Address - Street 1:720 GENERAL MOTORS RD
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:MI
Practice Address - Zip Code:48381-2220
Practice Address - Country:US
Practice Address - Phone:248-684-1775
Practice Address - Fax:248-684-7072
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704126691363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
P83965Medicare UPIN
MIP34780058Medicare PIN