Healthcare Provider Details

I. General information

NPI: 1093338345
Provider Name (Legal Business Name): DEJANET BAILEY FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2020
Last Update Date: 01/16/2025
Certification Date: 01/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 MDG UNIT 5142
APO AP
96368
US

IV. Provider business mailing address

2121 I ST NW
WASHINGTON DC
20052-0086
US

V. Phone/Fax

Practice location:
  • Phone: 98-938-1111
  • Fax:
Mailing address:
  • Phone: 240-899-9377
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number316730
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95145689
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number351922
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code163WM1400X
TaxonomyNurse Massage Therapist (NMT)
License Number1672
License Number StateNC
# 5
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3018187
License Number StateKY
# 6
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1047862
License Number StateDC
# 7
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number258848
License Number StateMT
# 8
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1036437
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: