Provider Demographics
NPI:1780232488
Name:BAILEY, ANDREA NICOL (RN)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:NICOL
Last Name:BAILEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14615 NE N WOODINVILLE WAY STE 108
Mailing Address - Street 2:
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98072-8492
Mailing Address - Country:US
Mailing Address - Phone:206-550-1972
Mailing Address - Fax:
Practice Address - Street 1:14615 NE N WOODINVILLE WAY STE 108
Practice Address - Street 2:
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98072-8492
Practice Address - Country:US
Practice Address - Phone:206-550-1972
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-27
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00080628163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health