Provider Demographics
NPI:1457095705
Name:BAILEY, DELISE
Entity Type:Individual
Prefix:
First Name:DELISE
Middle Name:
Last Name:BAILEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DELISE
Other - Middle Name:
Other - Last Name:SATTERFIELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5610 E CENTRAL TEXAS EXPY STE 1
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76543-5600
Mailing Address - Country:US
Mailing Address - Phone:254-690-8887
Mailing Address - Fax:
Practice Address - Street 1:5610 E CENTRAL TEXAS EXPY STE 1
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76543-5600
Practice Address - Country:US
Practice Address - Phone:254-690-8887
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-22
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1073228363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily