Bailly, Michaela Charlotte
Bailly, Michaela Charlotte is an individual health care provider with primary practice located at 3917 West Rd Ste A , Los Alamos NM 87544-2292. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Bailly, Michaela Charlotte can be contacted via phone (505) 661-8900.Contact Information
Primary practice address
3917 West Rd Ste A
Los Alamos NM 87544-2292
Phone: (505) 661-8900
Fax: (505) 661-8916
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | PA2022-0098 | New Mexico |
Profile Details
| NPI number | 1205565504 |
|---|---|
| LBN Legal business name | Bailly, Michaela Charlotte |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 10th, 2022 |
| Last updated | Feb 19th, 2024 - about 9 months 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1205565504 | NPPES |
| New Mexico | Other | PA2022-0098 | NEW MEXICO MEDICAL BOARD LICENSE |
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