Healthcare Provider Details

I. General information

NPI: 1043248404
Provider Name (Legal Business Name): SARALEE A BAILEY CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 12/20/2024
Certification Date: 12/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

236 ALHAMBRA DR
BRISTOL TN
37620-7202
US

IV. Provider business mailing address

236 ALHAMBRA DR
BRISTOL TN
37620-7202
US

V. Phone/Fax

Practice location:
  • Phone: 423-383-8395
  • Fax:
Mailing address:
  • Phone: 423-573-1951
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number10732
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number3013888
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: