Provider Demographics
NPI:1396866174
Name:BAILEY, LINDA R (MSN APRN- BC)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:R
Last Name:BAILEY
Suffix:
Gender:F
Credentials:MSN APRN- BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:79 HAMMOND LN
Mailing Address - Street 2:SUITE 2
Mailing Address - City:PLATTSBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12901-2008
Mailing Address - Country:US
Mailing Address - Phone:518-563-5900
Mailing Address - Fax:518-563-5903
Practice Address - Street 1:79 HAMMOND LANE
Practice Address - Street 2:SUITE2
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12901-4706
Practice Address - Country:US
Practice Address - Phone:518-563-5900
Practice Address - Fax:518-563-5903
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2012-02-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VT1010008886363LA2200X
NYF3055691363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health