Provider Demographics
NPI:1184961385
Name:BAILEY, STEPHANIE SHENK (PA-C)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:SHENK
Last Name:BAILEY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:DANIELLE
Other - Last Name:SHENK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:190 CAMPUS BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-2872
Mailing Address - Country:US
Mailing Address - Phone:540-667-1727
Mailing Address - Fax:540-722-3373
Practice Address - Street 1:190 CAMPUS BLVD STE 400
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-2872
Practice Address - Country:US
Practice Address - Phone:540-667-1727
Practice Address - Fax:540-722-3373
Is Sole Proprietor?:No
Enumeration Date:2013-01-08
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110004108363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant