Provider Demographics
NPI:1487345005
Name:BAYLES, CLAUDINE
Entity type:Individual
Prefix:
First Name:CLAUDINE
Middle Name:
Last Name:BAYLES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CLAUDINE
Other - Middle Name:
Other - Last Name:TUDOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1020 ALLOUEZ DR
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:MI
Mailing Address - Zip Code:49120-8934
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:314 N IRONWOOD DR
Practice Address - Street 2:
Practice Address - City:MISHAWAKA
Practice Address - State:IN
Practice Address - Zip Code:46544-1543
Practice Address - Country:US
Practice Address - Phone:574-254-2323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-16
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5351016849390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program