Healthcare Provider Details

I. General information

NPI: 1275457798
Provider Name (Legal Business Name): BAILEY KNOLL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BAILEY STOKES

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

521 N YOUNG ST
KENNEWICK WA
99336-7806
US

IV. Provider business mailing address

5308 MARINER LN
PASCO WA
99301-7866
US

V. Phone/Fax

Practice location:
  • Phone: 509-221-5222
  • Fax:
Mailing address:
  • Phone: 352-256-0672
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberARNP.AP.70152278-NP
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: