Provider Demographics
NPI:1215909569
Name:BAILLIO, SHEILA (RN)
Entity type:Individual
Prefix:
First Name:SHEILA
Middle Name:
Last Name:BAILLIO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 AUDUBON AVE
Mailing Address - Street 2:SUITE S4
Mailing Address - City:THIBODAUX
Mailing Address - State:LA
Mailing Address - Zip Code:70301-4957
Mailing Address - Country:US
Mailing Address - Phone:985-447-5939
Mailing Address - Fax:985-448-1521
Practice Address - Street 1:1101 AUDUBON AVE
Practice Address - Street 2:SUITE S4
Practice Address - City:THIBODAUX
Practice Address - State:LA
Practice Address - Zip Code:70301-4957
Practice Address - Country:US
Practice Address - Phone:985-447-5939
Practice Address - Fax:985-448-1521
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN0641781163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse