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General NPI Number Information
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NPI Number | 1053064717
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Entity Type | Individual
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Provider Name | CONSTANCE GAINEY BAILEY FNP
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Gender | Female
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Dates
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Enumeration Date | 02/01/2022
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Last Update Date | 02/04/2025
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Provider Practice Location Address
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Address Line | 439 NORTH ST
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City | BAMBERG
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State | SC
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Zip | 29003-1317
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Country | US
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Telephone | 803-245-7525
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Fax | 762-212-4581
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Provider Business Mailing Address
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Address Line | 187 MCBOW DR
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City | ROWESVILLE
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State | SC
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Zip | 29133-9594
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Country | US
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Telephone | 803-682-4322
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Fax |
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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 | 25768
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License Number State | SC
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