Provider Demographics
NPI:1851532154
Name:BAILEY, MELISSA MICHELLE (RN)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:MICHELLE
Last Name:BAILEY
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 1:416 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:HOUGHTON LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:48629-9766
Mailing Address - Country:US
Mailing Address - Phone:989-445-0278
Mailing Address - Fax:
Practice Address - Street 1:416 MAPLE ST
Practice Address - Street 2:
Practice Address - City:HOUGHTON LAKE
Practice Address - State:MI
Practice Address - Zip Code:48629-9766
Practice Address - Country:US
Practice Address - Phone:989-445-0278
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-16
Last Update Date:2009-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704256599163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse