Provider Demographics
NPI:1265076061
Name:STOLLY, BAILEY M (CNP)
Entity type:Individual
Prefix:
First Name:BAILEY
Middle Name:M
Last Name:STOLLY
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:BAILEY
Other - Middle Name:M
Other - Last Name:CALVELAGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNP
Mailing Address - Street 1:3578 FISHINGER BLVD
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-7503
Mailing Address - Country:US
Mailing Address - Phone:614-457-4806
Mailing Address - Fax:614-457-0269
Practice Address - Street 1:3578 FISHINGER BLVD
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-7503
Practice Address - Country:US
Practice Address - Phone:614-457-4806
Practice Address - Fax:614-457-0269
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-05
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.024791363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily