Provider Demographics
NPI:1558764167
Name:BAILEY, FELECIA (FNP)
Entity Type:Individual
Prefix:
First Name:FELECIA
Middle Name:
Last Name:BAILEY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13642 NIGHT SKY DR
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20906-5802
Mailing Address - Country:US
Mailing Address - Phone:301-933-8979
Mailing Address - Fax:
Practice Address - Street 1:12000 CHERRY HILL RD
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-1985
Practice Address - Country:US
Practice Address - Phone:301-586-0724
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-27
Last Update Date:2016-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDAC001312363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily