Provider Demographics
NPI:1245125608
Name:MAZUREK, BAILEY MORGAN LANNAN (FNP)
Entity type:Individual
Prefix:
First Name:BAILEY
Middle Name:MORGAN LANNAN
Last Name:MAZUREK
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2592 N WILLOW WAY
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-4249
Mailing Address - Country:US
Mailing Address - Phone:317-373-1482
Mailing Address - Fax:
Practice Address - Street 1:2592 N WILLOW WAY
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46268-4249
Practice Address - Country:US
Practice Address - Phone:317-373-1482
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-09
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INF05250632363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily