Provider Demographics
NPI:1477548600
Name:BAILEY, TANYA (CNM)
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:
Last Name:BAILEY
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 HOLBROOK STREET
Mailing Address - Street 2:OB-GYN ASSOCIATES
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24541
Mailing Address - Country:US
Mailing Address - Phone:434-792-7765
Mailing Address - Fax:434-793-4061
Practice Address - Street 1:101 HOLBROOK STREET
Practice Address - Street 2:OB-GYN ASSOCIATES
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24541
Practice Address - Country:US
Practice Address - Phone:434-792-7765
Practice Address - Fax:434-793-4061
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC10666CNM293367A00000X
NCNC293 ACNM10666367A00000X
VA0024180078367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife