Provider Demographics
NPI:1659980431
Name:BURNS, BAYLEE MARIE (PA-C)
Entity Type:Individual
Prefix:
First Name:BAYLEE
Middle Name:MARIE
Last Name:BURNS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2515 JAY AVE APT 202
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44113-3095
Mailing Address - Country:US
Mailing Address - Phone:814-881-6860
Mailing Address - Fax:
Practice Address - Street 1:3975 EMBASSY PKWY
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44333-8320
Practice Address - Country:US
Practice Address - Phone:330-668-4040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-28
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.006517RX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant