Provider Demographics
NPI:1700954740
Name:BAILEY, HEIDI KATHALEEN (PA-C)
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:KATHALEEN
Last Name:BAILEY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5352 DUCHESNE CT
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104-5441
Mailing Address - Country:US
Mailing Address - Phone:303-805-4771
Mailing Address - Fax:303-805-4771
Practice Address - Street 1:4386 TRAIL BOSS DR
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80104-7512
Practice Address - Country:US
Practice Address - Phone:303-688-8666
Practice Address - Fax:303-688-8260
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO1621363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant