Provider Demographics
NPI:1851993067
Name:BAILEY, JACQUELINE KAY
Entity Type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:KAY
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 1:8270 CINCINNATI ZANESVILLE RD SW
Mailing Address - Street 2:
Mailing Address - City:AMANDA
Mailing Address - State:OH
Mailing Address - Zip Code:43102-9730
Mailing Address - Country:US
Mailing Address - Phone:740-415-6321
Mailing Address - Fax:
Practice Address - Street 1:8270 CINCINNATI ZANESVILLE RD SW
Practice Address - Street 2:
Practice Address - City:AMANDA
Practice Address - State:OH
Practice Address - Zip Code:43102-9730
Practice Address - Country:US
Practice Address - Phone:740-415-6321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-12
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health