Healthcare Provider Details

I. General information

NPI: 1003613977
Provider Name (Legal Business Name): ALICIA NICOLE BAILEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/27/2025
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2304 ARROWOOD RD
MIDLOTHIAN VA
23112-4037
US

IV. Provider business mailing address

2304 ARROWOOD RD
MIDLOTHIAN VA
23112-4037
US

V. Phone/Fax

Practice location:
  • Phone: 804-381-8608
  • Fax:
Mailing address:
  • Phone: 804-381-8608
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: