Provider Demographics
NPI:1730285909
Name:BAILEY, RITA GAY (RD LD)
Entity Type:Individual
Prefix:MRS
First Name:RITA
Middle Name:GAY
Last Name:BAILEY
Suffix:
Gender:F
Credentials:RD LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 CASCADE DR
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42003-1160
Mailing Address - Country:US
Mailing Address - Phone:270-898-6691
Mailing Address - Fax:270-444-2977
Practice Address - Street 1:1530 LONE OAK RD
Practice Address - Street 2:DIETARY DEPT
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42003-7901
Practice Address - Country:US
Practice Address - Phone:270-444-2873
Practice Address - Fax:270-444-2977
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0364133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered