Provider Demographics
NPI:1962427070
Name:BAYES, MYRA ALICE (CNM)
Entity type:Individual
Prefix:MRS
First Name:MYRA
Middle Name:ALICE
Last Name:BAYES
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24730 PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:PLAQUEMINE
Mailing Address - State:LA
Mailing Address - Zip Code:70764-6827
Mailing Address - Country:US
Mailing Address - Phone:225-687-0248
Mailing Address - Fax:225-687-8395
Practice Address - Street 1:24730 PLAZA DR
Practice Address - Street 2:
Practice Address - City:PLAQUEMINE
Practice Address - State:LA
Practice Address - Zip Code:70764-6827
Practice Address - Country:US
Practice Address - Phone:225-687-0248
Practice Address - Fax:225-687-8395
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2013-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP03716207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS05573041Medicaid
LA1482048Medicaid
274646YH3VMedicare PIN