Provider Demographics
NPI:1659089787
Name:QUINN, BAILEY AURORA
Entity Type:Individual
Prefix:
First Name:BAILEY
Middle Name:AURORA
Last Name:QUINN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BAILEY
Other - Middle Name:AURORA
Other - Last Name:CAROTHERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14 GRANTS LAKE CIR
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-1382
Mailing Address - Country:US
Mailing Address - Phone:805-844-0880
Mailing Address - Fax:
Practice Address - Street 1:14 GRANTS LAKE CIR
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-1382
Practice Address - Country:US
Practice Address - Phone:805-844-0880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-08
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX939514OtherREGISTERED NURSE