Provider Demographics
NPI:1811312994
Name:BAILEY, ELIZABETH ANN (DNP)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:ANN
Last Name:BAILEY
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:ANN
Other - Last Name:NORTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DNP
Mailing Address - Street 1:PO BOX 779
Mailing Address - Street 2:404 NORTH CHESTNUT STREET
Mailing Address - City:JOHNSON
Mailing Address - State:KS
Mailing Address - Zip Code:67855
Mailing Address - Country:US
Mailing Address - Phone:620-492-1400
Mailing Address - Fax:620-492-2589
Practice Address - Street 1:404 NORTH CHESTNUT STREET
Practice Address - Street 2:
Practice Address - City:JOHNSON
Practice Address - State:KS
Practice Address - Zip Code:67855
Practice Address - Country:US
Practice Address - Phone:620-492-1400
Practice Address - Fax:620-492-2589
Is Sole Proprietor?:No
Enumeration Date:2014-02-25
Last Update Date:2017-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN18363363L00000X
NC5008251363L00000X
KS5377238061363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3710089Medicaid
3710089Medicare PIN