Healthcare Provider Details

I. General information

NPI: 1558288415
Provider Name (Legal Business Name): ALEXANDRIA EBEL BAILLEY PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

162 SEVEN FARMS DR STE 210
DANIEL ISLAND SC
29492-8230
US

IV. Provider business mailing address

162 SEVEN FARMS DR STE 210
DANIEL ISLAND SC
29492-8230
US

V. Phone/Fax

Practice location:
  • Phone: 843-884-1341
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: