Provider Demographics
NPI:1194294728
Name:BALES, HAILEE PAIGE (LVN)
Entity type:Individual
Prefix:
First Name:HAILEE
Middle Name:PAIGE
Last Name:BALES
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2901
Mailing Address - Street 2:
Mailing Address - City:KILGORE
Mailing Address - State:TX
Mailing Address - Zip Code:75663-2901
Mailing Address - Country:US
Mailing Address - Phone:903-806-4541
Mailing Address - Fax:
Practice Address - Street 1:701 EDGEWATER DR STE 300
Practice Address - Street 2:
Practice Address - City:WAKEFIELD
Practice Address - State:MA
Practice Address - Zip Code:01880-6242
Practice Address - Country:US
Practice Address - Phone:781-486-4109
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-13
Last Update Date:2018-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX346257164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse