Provider Demographics
NPI:1831950583
Name:WHITBECK, BAILEY MOLITOR (FNP-BC)
Entity type:Individual
Prefix:
First Name:BAILEY
Middle Name:MOLITOR
Last Name:WHITBECK
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:BAILEY
Other - Middle Name:
Other - Last Name:MOLITOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:22 NEW SCOTLAND AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-3795
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:22 NEW SCOTLAND AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3795
Practice Address - Country:US
Practice Address - Phone:518-262-5120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-19
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF35328701363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily