Provider Demographics
NPI:1912252685
Name:BAILEY, LAUREN MCINERNEY (CRNP)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:MCINERNEY
Last Name:BAILEY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 WILLOWBROOK LN
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19382-5576
Mailing Address - Country:US
Mailing Address - Phone:610-696-8900
Mailing Address - Fax:
Practice Address - Street 1:210 WILLOWBROOK LN
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19382-5576
Practice Address - Country:US
Practice Address - Phone:610-696-8900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-19
Last Update Date:2019-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0260033316163W00000X
VT1010089774363L00000X
PASP019660363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1010089774OtherSTATE LICENSE
VT1021074Medicaid
VT002961301Medicare PIN