| Doctor Name: | NICHELLE BAILEY |
| NPI Number: | 1184086738 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 1640 Redstone Center Dr Suite 200 Park City, UT - 840987605 |
| Business Phone Number: | 8664746677 |
| Business Fax Number: | |
| Mailing Address: | 1640 Redstone Center Dr, Suite 200 PARK CITY |
| State: | UT |
| Postal Code: | 840987605 |
| Phone Number: | 8664746677 |
| Fax Number: | |
| NPI Enumeration Date: | 03/23/2016 |
| NPI Last Update Date: | 03/23/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 146M00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Emergency Medical Service Providers |
| Taxonomy Classification: | Emergency Medical Technician, Intermediate |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An Intermediate EMT is an individual trained and certified to perform intermediate life support treatment in medical emergencies based on individual state boards. |