Provider Demographics
NPI:1184455305
Name:SANDERS, BAILEY NICOLE (PHARMD)
Entity type:Individual
Prefix:
First Name:BAILEY
Middle Name:NICOLE
Last Name:SANDERS
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 1:805 HIGHWAY 278 E
Mailing Address - Street 2:
Mailing Address - City:AMORY
Mailing Address - State:MS
Mailing Address - Zip Code:38821-5304
Mailing Address - Country:US
Mailing Address - Phone:662-250-9603
Mailing Address - Fax:662-256-8493
Practice Address - Street 1:805 HIGHWAY 278 E
Practice Address - Street 2:
Practice Address - City:AMORY
Practice Address - State:MS
Practice Address - Zip Code:38821-5304
Practice Address - Country:US
Practice Address - Phone:662-256-9603
Practice Address - Fax:662-256-8495
Is Sole Proprietor?:No
Enumeration Date:2024-08-09
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-101655183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist