=====================================================
General NPI Number Information
=====================================================
NPI Number | 1306644711
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BAILEY RENEE MORAES APRN-CNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/04/2025
-----------------------------------------------------
Last Update Date | 11/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8400 E BROAD ST
-----------------------------------------------------
City | REYNOLDSBURG
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43068-9749
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 614-328-8090
-----------------------------------------------------
Fax | 614-575-4797
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 7527
-----------------------------------------------------
City | DUBLIN
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43017-0727
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 614-544-6210
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP2300X
-----------------------------------------------------
Taxonomy Name | Primary Care Nurse Practitioner
-----------------------------------------------------
License Number | APRN.CNP.0039279
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 163W00000X
-----------------------------------------------------
Taxonomy Name | Registered Nurse
-----------------------------------------------------
License Number | RN.531192
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------