Provider Demographics
NPI:1275957490
Name:BAILEY, FELICIA ANTOINETTE (LPN)
Entity Type:Individual
Prefix:
First Name:FELICIA
Middle Name:ANTOINETTE
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 1:5602 CRENSHAW RD.
Mailing Address - Street 2:#1634
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23227
Mailing Address - Country:US
Mailing Address - Phone:804-400-9845
Mailing Address - Fax:
Practice Address - Street 1:2414 HOMEVIEW DR.
Practice Address - Street 2:
Practice Address - City:HENRIO
Practice Address - State:VA
Practice Address - Zip Code:23294-4446
Practice Address - Country:US
Practice Address - Phone:804-400-9845
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-07
Last Update Date:2014-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0002077614163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse