Provider Demographics
NPI:1184021164
Name:BAILEY, TERESIA C (NP-C)
Entity Type:Individual
Prefix:MS
First Name:TERESIA
Middle Name:C
Last Name:BAILEY
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1406 TUSCULUM BLVD STE 2000
Mailing Address - Street 2:
Mailing Address - City:GREENEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37745-4338
Mailing Address - Country:US
Mailing Address - Phone:423-787-7080
Mailing Address - Fax:423-787-7087
Practice Address - Street 1:1406 TUSCULUM BLVD STE 2000
Practice Address - Street 2:
Practice Address - City:GREENEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37745-4338
Practice Address - Country:US
Practice Address - Phone:423-787-7080
Practice Address - Fax:423-787-7087
Is Sole Proprietor?:No
Enumeration Date:2014-11-19
Last Update Date:2015-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000164099163W00000X
TNAPN0000018637363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse