Provider Demographics
NPI:1720406630
Name:BAILEY, ANNE (LAC)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:BAILEY
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4505 FAIR MEADOW LN
Mailing Address - Street 2:SUITE 215
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-6449
Mailing Address - Country:US
Mailing Address - Phone:919-787-7131
Mailing Address - Fax:
Practice Address - Street 1:4505 FAIR MEADOW LN
Practice Address - Street 2:SUITE 215
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-6449
Practice Address - Country:US
Practice Address - Phone:919-787-7131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-29
Last Update Date:2014-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC374171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist