Healthcare Provider Details

I. General information

NPI: 1770028409
Provider Name (Legal Business Name): SEVARA JEAN BAILEY NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/04/2017
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8320 W SUNRISE BLVD STE 208
PLANTATION FL
33322-5432
US

IV. Provider business mailing address

PO BOX 1200
PLEASANT GROVE UT
84062-1200
US

V. Phone/Fax

Practice location:
  • Phone: 800-640-3451
  • Fax:
Mailing address:
  • Phone: 800-640-3451
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN186280
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number346180
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number721119-1
License Number StateNY
# 4
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN292105
License Number StateGA
# 5
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number246154
License Number StateAZ
# 6
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11008563
License Number StateFL
# 7
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberTEMP246154
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: