Provider Demographics
NPI:1316557895
Name:CAUDILL, BAILEY KATHLEEN (PHARMD)
Entity Type:Individual
Prefix:
First Name:BAILEY
Middle Name:KATHLEEN
Last Name:CAUDILL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5133 RYAN ALLEN CIR
Mailing Address - Street 2:
Mailing Address - City:WHITES CREEK
Mailing Address - State:TN
Mailing Address - Zip Code:37189-5200
Mailing Address - Country:US
Mailing Address - Phone:859-954-0709
Mailing Address - Fax:
Practice Address - Street 1:7604 HWY 70 S
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37221-1852
Practice Address - Country:US
Practice Address - Phone:615-646-7310
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-09
Last Update Date:2020-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN44140183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist