Provider Demographics
NPI:1316264831
Name:BAILEY, EVELYN MAIERS (RESPIRATORY THERAPY)
Entity type:Individual
Prefix:
First Name:EVELYN
Middle Name:MAIERS
Last Name:BAILEY
Suffix:
Gender:F
Credentials:RESPIRATORY THERAPY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 RIVER LOOP RD
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:NC
Mailing Address - Zip Code:28012-2734
Mailing Address - Country:US
Mailing Address - Phone:704-813-0471
Mailing Address - Fax:
Practice Address - Street 1:230 RIVER LOOP RD
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:NC
Practice Address - Zip Code:28012
Practice Address - Country:US
Practice Address - Phone:704-813-0471
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-23
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA-905227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1316264831Medicare NSC