Provider Demographics
NPI:1598480857
Name:HARDGROVE, BAILEE (RN)
Entity Type:Individual
Prefix:
First Name:BAILEE
Middle Name:
Last Name:HARDGROVE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:BAILEE
Other - Middle Name:
Other - Last Name:WOODIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6235 KESTRAL VIEW RD
Mailing Address - Street 2:
Mailing Address - City:TRUSSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35173-6318
Mailing Address - Country:US
Mailing Address - Phone:850-381-2019
Mailing Address - Fax:
Practice Address - Street 1:1600 7TH AVE S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-1711
Practice Address - Country:US
Practice Address - Phone:205-638-9100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-10
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-173641163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse