Healthcare Provider Details

I. General information

NPI: 1386709996
Provider Name (Legal Business Name): KAREN R BAILEY MS,RD,LD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/26/2006
Last Update Date: 12/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 HOSPITAL DRIVE SUITE 200 CASTROP CENTER
ATHENS OH
45701
US

IV. Provider business mailing address

5450 FRANTZ RD STE 360
DUBLIN OH
43016-4141
US

V. Phone/Fax

Practice location:
  • Phone: 740-566-4870
  • Fax: 740-566-4871
Mailing address:
  • Phone: 614-544-6155
  • Fax: 614-544-6370

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberLD.1234
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: