Provider Demographics
NPI:1619216736
Name:BAILEY, JESSICA ELAINE (FNP-BC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:ELAINE
Last Name:BAILEY
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:ELAINE
Other - Last Name:DURST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:719 MCCULLOCH RD
Mailing Address - Street 2:
Mailing Address - City:POINT PLEASANT
Mailing Address - State:WV
Mailing Address - Zip Code:25550-1932
Mailing Address - Country:US
Mailing Address - Phone:304-593-2202
Mailing Address - Fax:
Practice Address - Street 1:2520 VALLEY DR
Practice Address - Street 2:
Practice Address - City:POINT PLEASANT
Practice Address - State:WV
Practice Address - Zip Code:25550
Practice Address - Country:US
Practice Address - Phone:304-675-4340
Practice Address - Fax:304-675-6911
Is Sole Proprietor?:No
Enumeration Date:2013-02-08
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVAPRN77792-FNP-BC363L00000X, 363LF0000X
WV77792163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse