Provider Demographics
NPI:1659134849
Name:BAILEY, HANNAH FORREST
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:FORREST
Last Name:BAILEY
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 1:1360 APPLING DR UNIT 209
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-4779
Mailing Address - Country:US
Mailing Address - Phone:803-605-3636
Mailing Address - Fax:
Practice Address - Street 1:1360 APPLING DR UNIT 209
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-4779
Practice Address - Country:US
Practice Address - Phone:803-605-3636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-01
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant