Healthcare Provider Details

I. General information

NPI: 1821683558
Provider Name (Legal Business Name): JEFFREY SCOTT BAILEY DNP, FNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/04/2021
Last Update Date: 10/03/2023
Certification Date: 08/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

198 COLLEGE HILL RD
CLINTON NY
13323-1295
US

IV. Provider business mailing address

1 ATWELL RD
COOPERSTOWN NY
13326-1394
US

V. Phone/Fax

Practice location:
  • Phone: 315-859-4111
  • Fax: 315-859-4963
Mailing address:
  • Phone: 607-547-3480
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WX0200X
TaxonomyOncology Registered Nurse
License Number779123
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number347691
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: