Individual
MARY J BAILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LMNT
Contact information
Practice address
2620 W FAIDLEY AVE, GRAND ISLAND, NE 68803-4205
(308) 398-5315
(308) 398-6565
Mailing address
2620 W FAIDLEY AVE, P O BOX 9804, GRAND ISLAND, NE 68803-4205
(308) 398-5315
(308) 398-6565
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
415
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
415
LMNT
NE
Enumeration date
11/01/2006
Last updated
07/09/2007
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