Provider Demographics
NPI:1649466202
Name:BAILEY, BRIDGIT LASHEA (COTA)
Entity type:Individual
Prefix:MISS
First Name:BRIDGIT
Middle Name:LASHEA
Last Name:BAILEY
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2924 DEARBORN DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27704-3427
Mailing Address - Country:US
Mailing Address - Phone:919-220-2649
Mailing Address - Fax:
Practice Address - Street 1:500 PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:NC
Practice Address - Zip Code:27565-2543
Practice Address - Country:US
Practice Address - Phone:919-692-1005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-18
Last Update Date:2007-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6294163WX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0106XNursing Service ProvidersRegistered NurseOccupational Health