Provider Demographics
NPI:1164019535
Name:BAILEY, PATRICIA WYNN
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:WYNN
Last Name:BAILEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 COUNTRY CREEK DR
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-6448
Mailing Address - Country:US
Mailing Address - Phone:419-423-3310
Mailing Address - Fax:
Practice Address - Street 1:1020 COUNTRY CREEK DR
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-6448
Practice Address - Country:US
Practice Address - Phone:419-423-3310
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-30
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH32004043747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant