Provider Demographics
NPI:1780135848
Name:BAILEY, CARLY JOY (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:CARLY
Middle Name:JOY
Last Name:BAILEY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MISS
Other - First Name:CARLY
Other - Middle Name:JOY
Other - Last Name:GENOVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:9706 STATE ROUTE 305
Mailing Address - Street 2:
Mailing Address - City:GARRETTSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44231-9680
Mailing Address - Country:US
Mailing Address - Phone:440-487-9982
Mailing Address - Fax:
Practice Address - Street 1:30680 BAINBRIDGE RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44139-2282
Practice Address - Country:US
Practice Address - Phone:440-542-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-24
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.019795363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily