Healthcare Provider Details

I. General information

NPI: 1083963581
Provider Name (Legal Business Name): CATHERINE A BAILEY FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2012
Last Update Date: 03/15/2021
Certification Date: 03/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 N BUCKEYE ST
OSGOOD IN
47037-1134
US

IV. Provider business mailing address

PO BOX 236
BATESVILLE IN
47006-0236
US

V. Phone/Fax

Practice location:
  • Phone: 812-689-3424
  • Fax: 812-933-5237
Mailing address:
  • Phone: 812-933-5441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71004210A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: