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General NPI Number Information
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NPI Number | 1073299285
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Entity Type | Individual
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Provider Name | DEMETRIA DENISE BAILEY ADMINISTRATOR RHA
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Gender | Female
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Dates
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Enumeration Date | 06/22/2023
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Last Update Date | 10/16/2025
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Provider Practice Location Address
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Address Line | 2849 SHADY OAK AVE
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City | MEMPHIS
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State | TN
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Zip | 38112-4656
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Country | US
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Telephone | 901-340-4623
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Fax | 901-370-2268
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Provider Business Mailing Address
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Address Line | 2849 SHADY OAK AVE
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City | MEMPHIS
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State | TN
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Zip | 38112-4656
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Country | US
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Telephone | 901-340-4623
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Fax | 901-370-2268
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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 | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 1000000038828
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License Number State | TN
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