Provider Demographics
NPI:1972741478
Name:BAILEY, CRYSTAL JEAN (CNM)
Entity Type:Individual
Prefix:MS
First Name:CRYSTAL
Middle Name:JEAN
Last Name:BAILEY
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1080 NEAL ST
Mailing Address - Street 2:STE 200
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38501-0942
Mailing Address - Country:US
Mailing Address - Phone:931-520-1529
Mailing Address - Fax:931-372-2751
Practice Address - Street 1:1080 NEAL ST
Practice Address - Street 2:STE 200
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-0942
Practice Address - Country:US
Practice Address - Phone:931-520-1529
Practice Address - Fax:931-372-2751
Is Sole Proprietor?:No
Enumeration Date:2009-01-22
Last Update Date:2009-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN164572163W00000X
TN13378176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No163W00000XNursing Service ProvidersRegistered Nurse