Provider Demographics
NPI:1871347260
Name:GIFFORD, BAILEY LYNNE (MD)
Entity type:Individual
Prefix:
First Name:BAILEY
Middle Name:LYNNE
Last Name:GIFFORD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2635 UNIVERSITY AVE W STE 160
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55114-8665
Mailing Address - Country:US
Mailing Address - Phone:952-967-7960
Mailing Address - Fax:651-293-8293
Practice Address - Street 1:2635 UNIVERSITY AVE W STE 160
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55114-1271
Practice Address - Country:US
Practice Address - Phone:612-626-4939
Practice Address - Fax:651-293-8293
Is Sole Proprietor?:No
Enumeration Date:2024-04-12
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program