Provider Demographics
NPI:1174157531
Name:GAGER, BAILEY GRAY (RD)
Entity type:Individual
Prefix:
First Name:BAILEY
Middle Name:GRAY
Last Name:GAGER
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:BAILEY
Other - Middle Name:GRAY
Other - Last Name:PARMELEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:20699 3 MILE RD
Mailing Address - Street 2:
Mailing Address - City:REED CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49677-8050
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4393 220TH AVE
Practice Address - Street 2:
Practice Address - City:REED CITY
Practice Address - State:MI
Practice Address - Zip Code:49677-8594
Practice Address - Country:US
Practice Address - Phone:231-832-6618
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-25
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI86103304133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered