Individual
M JUDY BAILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
111 S FRONT ST, HARRISBURG, PA 17101-2010
(717) 782-5470
(717) 782-5820
Mailing address
118 WASHINGTON ST, HARRISBURG, PA 17104-1677
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN223850L
PA
367500000X
Certified Registered Nurse Anesthetist
Primary
RN-223850-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1436506
BLUE SHIELD
—
05
—
430058228
—
PA
01
—
CC9810
RR GROUP #
—
Enumeration date
09/01/2006
Last updated
05/29/2009
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