Provider Demographics
NPI:1326329566
Name:BAILEY, MARY ELAINE (NP)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:ELAINE
Last Name:BAILEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Mailing Address - Street 1:102 WOODMONT BLVD STE 600
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-5250
Mailing Address - Country:US
Mailing Address - Phone:615-315-5257
Mailing Address - Fax:615-692-0547
Practice Address - Street 1:2210 STATE ROAD 580
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33763-1126
Practice Address - Country:US
Practice Address - Phone:727-615-3133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-01
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GARN181781363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GARN181781OtherSTATE LICENSE