Provider Demographics
NPI:1952601809
Name:BAILEY, BILLIE JO (FNP)
Entity Type:Individual
Prefix:
First Name:BILLIE
Middle Name:JO
Last Name:BAILEY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:BILLIE
Other - Middle Name:HACKNEY
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:1164 MAULD RD
Mailing Address - Street 2:
Mailing Address - City:WINNSBORO
Mailing Address - State:LA
Mailing Address - Zip Code:71295-5782
Mailing Address - Country:US
Mailing Address - Phone:318-435-8020
Mailing Address - Fax:318-435-8099
Practice Address - Street 1:101 FAIR AVENUE
Practice Address - Street 2:
Practice Address - City:WINNSBORO
Practice Address - State:LA
Practice Address - Zip Code:71295-2116
Practice Address - Country:US
Practice Address - Phone:318-435-8020
Practice Address - Fax:318-435-8099
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-26
Last Update Date:2012-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP06297363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily