Provider Demographics
NPI:1063172401
Name:WHITE-GEISLER, BAYLEIGH AUGUSTA (PA-C)
Entity type:Individual
Prefix:
First Name:BAYLEIGH
Middle Name:AUGUSTA
Last Name:WHITE-GEISLER
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:BAYLEIGH
Other - Middle Name:AUGUSTA
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:611 W PARK ST
Mailing Address - Street 2:
Mailing Address - City:URBANA
Mailing Address - State:IL
Mailing Address - Zip Code:61801-2501
Mailing Address - Country:US
Mailing Address - Phone:217-902-6954
Mailing Address - Fax:217-902-7711
Practice Address - Street 1:611 W PARK ST
Practice Address - Street 2:
Practice Address - City:URBANA
Practice Address - State:IL
Practice Address - Zip Code:61801-2501
Practice Address - Country:US
Practice Address - Phone:217-904-7000
Practice Address - Fax:217-904-7751
Is Sole Proprietor?:No
Enumeration Date:2021-12-27
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085010978363AM0700X
363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical