Provider Demographics
NPI:1659052371
Name:BAILEY, CARYL (CNP)
Entity Type:Individual
Prefix:
First Name:CARYL
Middle Name:
Last Name:BAILEY
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4220 ENDEAVOR DR UNIT 301
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45252-2323
Mailing Address - Country:US
Mailing Address - Phone:513-257-8713
Mailing Address - Fax:
Practice Address - Street 1:5215 DEERFIELD BLVD # A114
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-2509
Practice Address - Country:US
Practice Address - Phone:513-986-5201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-26
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0034399363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner