Individual
KRISTINE BAILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
305 E FAIRMOUNT AVE, STE 7, LAKEWOOD, NY 14750-2000
(716) 483-2603
(716) 526-4161
Mailing address
305 E FAIRMOUNT AVE, STE 7, LAKEWOOD, NY 14750-2000
(716) 483-2603
(716) 526-4161
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
564481
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F401349-1
NY
Other
Enumeration date
11/15/2007
Last updated
11/30/2010
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