Provider Demographics
NPI:1881966885
Name:BAILEY, ERIC LEON (CRNA)
Entity type:Individual
Prefix:MR
First Name:ERIC
Middle Name:LEON
Last Name:BAILEY
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:1372 VALENCIA ST
Mailing Address - Street 2:
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83301-5581
Mailing Address - Country:US
Mailing Address - Phone:208-731-0873
Mailing Address - Fax:
Practice Address - Street 1:801 POLE LINE RD W
Practice Address - Street 2:MAGIC VALLEY ANESTHESIOLOGY ASSOCIATES
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-5810
Practice Address - Country:US
Practice Address - Phone:208-358-2810
Practice Address - Fax:208-814-2921
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-06
Last Update Date:2012-02-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IDRNA-823A367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered