Provider Demographics
NPI:1770565681
Name:BAILEY, SHERRIE YVONNE (APRN)
Entity type:Individual
Prefix:
First Name:SHERRIE
Middle Name:YVONNE
Last Name:BAILEY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 PROFESSIONAL AVE
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:KY
Mailing Address - Zip Code:40391-1147
Mailing Address - Country:US
Mailing Address - Phone:859-744-4482
Mailing Address - Fax:859-744-0338
Practice Address - Street 1:400 PROFESSIONAL AVE
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:KY
Practice Address - Zip Code:40391-1147
Practice Address - Country:US
Practice Address - Phone:859-744-4482
Practice Address - Fax:859-744-0338
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2015-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1038730163WC1500X
KY864P363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100129980Medicaid
KY0281603Medicare PIN
KY0059623Medicare PIN
KY0281503Medicare PIN
KY0281903Medicare PIN
KY0281403Medicare PIN
KYK030290Medicare PIN
S99893Medicare UPIN
KY7100129980Medicaid
KY0281803Medicare PIN
KY0281703Medicare PIN