Provider Demographics
NPI:1205271319
Name:BAILEY, ANGELA YVONNE (LPN-IV)
Entity type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:YVONNE
Last Name:BAILEY
Suffix:
Gender:F
Credentials:LPN-IV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 S BOSTON ST
Mailing Address - Street 2:
Mailing Address - City:GALION
Mailing Address - State:OH
Mailing Address - Zip Code:44833-2507
Mailing Address - Country:US
Mailing Address - Phone:419-610-1383
Mailing Address - Fax:
Practice Address - Street 1:303 S BOSTON ST
Practice Address - Street 2:
Practice Address - City:GALION
Practice Address - State:OH
Practice Address - Zip Code:44833-2507
Practice Address - Country:US
Practice Address - Phone:419-610-1383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-02
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN128155 IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse