Healthcare Provider Details

I. General information

NPI: 1144146366
Provider Name (Legal Business Name): BOBBIE BAILEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

267 NANCY BAILEY DR
DRYDEN VA
24243-8105
US

IV. Provider business mailing address

267 NANCY BAILEY DR
DRYDEN VA
24243-8105
US

V. Phone/Fax

Practice location:
  • Phone: 276-346-2876
  • Fax:
Mailing address:
  • Phone: 276-346-2876
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License Number1101002034
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: