Healthcare Provider Details

I. General information

NPI: 1447892872
Provider Name (Legal Business Name): KATIE L. BAILEY NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2019
Last Update Date: 11/16/2022
Certification Date: 11/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 S MAIN ST
FRANKLINVILLE NY
14737-1224
US

IV. Provider business mailing address

535 MAIN ST STE 1
OLEAN NY
14760-1593
US

V. Phone/Fax

Practice location:
  • Phone: 716-676-2212
  • Fax: 716-676-2432
Mailing address:
  • Phone: 716-372-0141
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number309418
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: