Healthcare Provider Details

I. General information

NPI: 1831016351
Provider Name (Legal Business Name): CARTER BAILEY MARTIN RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1005 CITY AVE N
RIPLEY MS
38663-1414
US

IV. Provider business mailing address

1005 CITY AVE N
RIPLEY MS
38663-1414
US

V. Phone/Fax

Practice location:
  • Phone: 662-587-9221
  • Fax: 662-512-3454
Mailing address:
  • Phone: 662-837-9221
  • Fax: 662-512-3454

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number924187
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: