Individual
LISA S BAILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1195 N MAIN ST, PROVIDENCE, RI 02904-1824
(401) 861-3782
(401) 861-3782
Mailing address
1195 N MAIN ST, PROVIDENCE, RI 02904-1824
(401) 861-3782
(401) 383-5846
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
363AM0700X
Medical Physician Assistant
PA01080
RI
Other
Enumeration date
09/20/2018
Last updated
03/25/2020
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