MEDICARE: BAILEY DEVRIES APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	11027038	FL

General Provider Information

NPI Number	:	1154006054
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BAILEY DEVRIES APRN

Provider Business Mailing Address
First Line	:	13191 STARKEY RD STE 6
Second Line	:
City	:	LARGO
State	:	FL
Zip	:	33773-1438
Country	:	US
Telephone Number	:	727-458-9530
Fax Number	:

Provider Business Practice Location Address
First Line	:	13191 STARKEY RD STE 6
Second Line	:
City	:	LARGO
State	:	FL
Zip	:	33773-1438
Country	:	US
Telephone Number	:	727-458-9530
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/19/2023
Last Update Date	:	06/19/2023

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Directions to “ BAILEY DEVRIES APRN” Practice Location

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