Provider Demographics
NPI:1700514395
Name:BAYLESS, WENDY ELIZABETH (APRN)
Entity Type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:ELIZABETH
Last Name:BAYLESS
Suffix:
Gender:F
Credentials:APRN
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Mailing Address - Street 1:308 W 15TH ST
Mailing Address - Street 2:
Mailing Address - City:HOPKINSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42240-2038
Mailing Address - Country:US
Mailing Address - Phone:706-608-8662
Mailing Address - Fax:270-770-2221
Practice Address - Street 1:13 TOWN WEST RD STE B-3
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03264-3428
Practice Address - Country:US
Practice Address - Phone:603-945-8048
Practice Address - Fax:603-945-7110
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-11
Last Update Date:2023-06-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY3017993363LP0808X
NH068994-23363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health