Individual
KERI BAILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
161119
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04901363
MEDICAID PRACTICE NUMBER
CO
05
—
15380840
—
CO
01
—
37402552
MEDICAID PRACTICE NUMBER
CO
01
—
54552826
MEDICAID PRACTICE NUMBER
CO
01
—
809609
MEDICARE GROUP PTAN
CO
01
—
C809609
MEDICARE GROUP NUMBER
CO
Enumeration date
03/30/2007
Last updated
05/16/2008
Update your record
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