Provider Demographics
NPI:1326453895
Name:BAILEY, AMANDA WILLIS (NP)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:WILLIS
Last Name:BAILEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:501 MEDICAL CENTER DR
Mailing Address - Street 2:BOX30134 SUITE 100
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301-8124
Mailing Address - Country:US
Mailing Address - Phone:318-487-1358
Mailing Address - Fax:318-487-9584
Practice Address - Street 1:501 MEDICAL CENTER DR
Practice Address - Street 2:BOX30134 SUITE 100
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-8124
Practice Address - Country:US
Practice Address - Phone:318-487-1358
Practice Address - Fax:318-487-9584
Is Sole Proprietor?:No
Enumeration Date:2014-06-24
Last Update Date:2014-06-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LAAP07895363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics