Provider Demographics
NPI:1063814416
Name:BAILEY, ARLENE BROOKE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:ARLENE
Middle Name:BROOKE
Last Name:BAILEY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 N VINE ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIANA
Mailing Address - State:OH
Mailing Address - Zip Code:44408-1130
Mailing Address - Country:US
Mailing Address - Phone:330-482-3818
Mailing Address - Fax:
Practice Address - Street 1:700 COLUMBIANA WATERFORD RD
Practice Address - Street 2:
Practice Address - City:COLUMBIANA
Practice Address - State:OH
Practice Address - Zip Code:44408-9499
Practice Address - Country:US
Practice Address - Phone:330-482-3818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-17
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN109301164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse