Provider Demographics
NPI:1558828970
Name:SCOTT, BAYLEIGH CREEL
Entity Type:Individual
Prefix:
First Name:BAYLEIGH
Middle Name:CREEL
Last Name:SCOTT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6905 HIGHWAY 145 S
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39301-9771
Mailing Address - Country:US
Mailing Address - Phone:601-481-5105
Mailing Address - Fax:
Practice Address - Street 1:6905 HIGHWAY 145 S
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:MS
Practice Address - Zip Code:39301-9771
Practice Address - Country:US
Practice Address - Phone:601-282-3271
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-21
Last Update Date:2019-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS903162363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily