Provider Demographics
NPI:1740582790
Name:BAIZE, LEE ANN (RN)
Entity Type:Individual
Prefix:
First Name:LEE
Middle Name:ANN
Last Name:BAIZE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:GATESVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76528-2722
Mailing Address - Country:US
Mailing Address - Phone:254-681-2696
Mailing Address - Fax:
Practice Address - Street 1:304 LIBERTY ST
Practice Address - Street 2:
Practice Address - City:GATESVILLE
Practice Address - State:TX
Practice Address - Zip Code:76528-2722
Practice Address - Country:US
Practice Address - Phone:254-681-2696
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-24
Last Update Date:2010-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6694492163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse