person
Michaela Charlotte Bailly, PA-C
Medical Physician Assistant in Los Alamos, New Mexico
NPI 1205565504

Michaela Charlotte Bailly is a Medical Physician Assistant based in Los Alamos, NM and is specialized in Medical. Michaela Charlotte Bailly practices in Los Alamos, NM and has the professional credentials of PA-C. The NPI Number for Michaela Charlotte Bailly is 1205565504 and holds a License No. PA2022-0098 (New Mexico).

The current practice location address for Michaela Charlotte Bailly is 3917 West Rd Ste A, Los Alamos, NM and can be reached out via phone at 505-661-8900 and via fax at 505-661-8916.

Location: 3917 West Rd Ste A, Los Alamos, NM, 87544-2292
person
Provider Profile Details
NPI Number
1205565504
Provider Name
Michaela Charlotte Bailly
Credential
PA-C
Provider Entity Type
Individual
Gender
Female
Address
3917 West Rd Ste A, Los Alamos, NM, 87544-2292
Phone Number
505-661-8900
Fax Number
505-661-8916
Provider Enumeration Date
06/10/2022
Last Update Date
03/13/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
PA2022-0098 01 NM NEW MEXICO MEDICAL BOARD LICENSE
institution
Provider Business Practice Location Address Details
Address
3917 West Rd Ste A
City
State
Zip
87544-2292
Phone Number
505-661-8900
Fax Number
505-661-8916
person
Provider Business Mailing Address Details
Address
3917 West Rd Ste A
City
State
Zip
87544-2292
Phone Number
505-661-8900
Fax Number
505-661-8916
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
PA2022-0098 (New Mexico)
Definition
Definition to come...
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