Individual
MARTHA HELEN BAILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
790 FULLER AVE NE, GRAND RAPIDS, MI 49503-1918
(616) 336-3909
Mailing address
790 FULLER AVE NE, GRAND RAPIDS, MI 49503-1918
(616) 336-3909
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
4704254472
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704254472
RN
MI
Enumeration date
03/05/2021
Last updated
03/05/2021
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