Provider Demographics
NPI:1972279222
Name:BAILEY, CIARA JORDAN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CIARA
Middle Name:JORDAN
Last Name:BAILEY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 153
Mailing Address - Street 2:
Mailing Address - City:PAINTER
Mailing Address - State:VA
Mailing Address - Zip Code:23420-0153
Mailing Address - Country:US
Mailing Address - Phone:757-709-0474
Mailing Address - Fax:
Practice Address - Street 1:321 BATTLEFIELD BLVD S
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23322-5311
Practice Address - Country:US
Practice Address - Phone:757-546-8783
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-17
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202219828183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist