Provider Demographics
NPI:1154736916
Name:BAYLISS, KELSEY RENEE (RPH)
Entity type:Individual
Prefix:DR
First Name:KELSEY
Middle Name:RENEE
Last Name:BAYLISS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 S IOWA AVE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:IA
Mailing Address - Zip Code:52353-1736
Mailing Address - Country:US
Mailing Address - Phone:319-653-4646
Mailing Address - Fax:
Practice Address - Street 1:222 S IOWA AVE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:IA
Practice Address - Zip Code:52353
Practice Address - Country:US
Practice Address - Phone:319-653-4646
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-30
Last Update Date:2019-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA22227183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist