Healthcare Provider Details

I. General information

NPI: 1912814260
Provider Name (Legal Business Name): NEKEE NOELLE BAILEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1220 E NORTHSIDE DR STE 280
JACKSON MS
39211-5547
US

IV. Provider business mailing address

4555 HOLLY DR APT A6
JACKSON MS
39206-6024
US

V. Phone/Fax

Practice location:
  • Phone: 601-709-4300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number1789
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: