Healthcare Provider Details

I. General information

NPI: 1164993549
Provider Name (Legal Business Name): JACQUELINE MARIE BAILEY MA, HHA, PHLEB, EKG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: J.MARIE BAILEY AAS

II. Dates (important events)

Enumeration Date: 12/11/2018
Last Update Date: 12/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3382 DESHLER DR
CINCINNATI OH
45251-2106
US

IV. Provider business mailing address

1421 MEREDITH DR
CINCINNATI OH
45231-3215
US

V. Phone/Fax

Practice location:
  • Phone: 513-969-6190
  • Fax:
Mailing address:
  • Phone: 513-225-8611
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: