Provider Demographics
NPI:1780294439
Name:NEUBAUER, BAILEY ERIN
Entity type:Individual
Prefix:
First Name:BAILEY
Middle Name:ERIN
Last Name:NEUBAUER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1124 HIGHWAY 5 NE
Mailing Address - Street 2:
Mailing Address - City:BOTTINEAU
Mailing Address - State:ND
Mailing Address - Zip Code:58318-7100
Mailing Address - Country:US
Mailing Address - Phone:701-871-1410
Mailing Address - Fax:
Practice Address - Street 1:2111 LANDMARK CIR NW STE B
Practice Address - Street 2:
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58703-1967
Practice Address - Country:US
Practice Address - Phone:701-839-4102
Practice Address - Fax:701-838-9603
Is Sole Proprietor?:No
Enumeration Date:2020-08-07
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND2355225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist