Provider Demographics
NPI:1134555436
Name:BAILEY, TONYA (LPN)
Entity type:Individual
Prefix:
First Name:TONYA
Middle Name:
Last Name:BAILEY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:TONYA
Other - Middle Name:
Other - Last Name:ORCUTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:406 SENECA ST
Mailing Address - Street 2:
Mailing Address - City:ONEIDA
Mailing Address - State:NY
Mailing Address - Zip Code:13421-2026
Mailing Address - Country:US
Mailing Address - Phone:315-271-5148
Mailing Address - Fax:315-280-0725
Practice Address - Street 1:406 SENECA ST
Practice Address - Street 2:
Practice Address - City:ONEIDA
Practice Address - State:NY
Practice Address - Zip Code:13421-2026
Practice Address - Country:US
Practice Address - Phone:315-271-5148
Practice Address - Fax:315-280-0725
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-18
Last Update Date:2013-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY270504-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse