Healthcare Provider Details

I. General information

NPI: 1750034831
Provider Name (Legal Business Name): STACEY BETH BAILEY FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2022
Last Update Date: 06/30/2022
Certification Date: 06/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

351 VALLEY HEALTH WAY STE 300
FRONT ROYAL VA
22630-6480
US

IV. Provider business mailing address

36 LITTLE LONG MOUNTAIN RD
HUNTLY VA
22640-3116
US

V. Phone/Fax

Practice location:
  • Phone: 540-631-3700
  • Fax: 540-635-1673
Mailing address:
  • Phone: 540-635-9296
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number0024182373
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: