Bailly, Lita C

Bailly, Lita C is an individual health care provider with primary practice located at 1217 Bonita St , Grants NM 87020-2103. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Bailly, Lita C can be contacted via phone (505) 287-2950.

Contact Information

Primary practice address
1217 Bonita St Grants NM 87020-2103
Phone: (505) 287-2950
Fax: (505) 287-2403
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X R029543 Maine
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X AP081328 Maine

Profile Details

NPI number 1306856166
LBN Legal business name Bailly, Lita C
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 8th, 2006
Last updated Oct 27th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1306856166 NPPES
Maine MEDICAID 335260099

Popular Providers