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General NPI Number Information
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NPI Number | 1003161373
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Entity Type | Individual
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Provider Name | AMY BAILEY
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Gender | Female
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Dates
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Enumeration Date | 07/23/2012
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Last Update Date | 10/03/2012
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Provider Practice Location Address
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Address Line | 900 EARL FRYE BLVD SUITE A
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City | AMORY
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State | MS
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Zip | 38821-5507
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Country | US
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Telephone | 662-256-9331
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Fax | 662-256-9335
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Provider Business Mailing Address
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Address Line | 900 EARL FRYE BLVD SUITE A
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City | AMORY
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State | MS
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Zip | 38821-5507
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Country | US
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Telephone | 662-256-9331
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Fax | 662-256-9335
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R877157
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License Number State | MS
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