Provider Demographics
NPI:1730299777
Name:BAYLESS, KIMBERLEE MAREE (FNP; APN)
Entity Type:Individual
Prefix:
First Name:KIMBERLEE
Middle Name:MAREE
Last Name:BAYLESS
Suffix:
Gender:F
Credentials:FNP; APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 SIERRA ROSE DR
Mailing Address - Street 2:SUITE 4
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-2060
Mailing Address - Country:US
Mailing Address - Phone:775-689-5410
Mailing Address - Fax:775-689-5432
Practice Address - Street 1:605 SIERRA ROSE DR
Practice Address - Street 2:SUITE 4
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-2060
Practice Address - Country:US
Practice Address - Phone:775-689-5410
Practice Address - Fax:775-689-5432
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV700295363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily