Provider Demographics
NPI:1659134849
Name:BAILEY, HANNAH FORREST (PA-C)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:FORREST
Last Name:BAILEY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2220 ROCKY BAY CT
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27519-6689
Mailing Address - Country:US
Mailing Address - Phone:803-605-3636
Mailing Address - Fax:
Practice Address - Street 1:1619 BUFFALO LAKE RD
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27332-2537
Practice Address - Country:US
Practice Address - Phone:919-343-3435
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-01
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
NC001014808363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant