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General NPI Number Information
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NPI Number | 1306876099
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Entity Type | Individual
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Provider Name | BREANN LYN BAILEY MD
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Gender | Female
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 07/24/2016
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Provider Practice Location Address
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Address Line | 202 8TH ST
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City | RADFORD
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State | VA
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Zip | 24141-2426
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Country | US
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Telephone | 540-639-5188
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Fax | 540-639-9215
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Provider Business Mailing Address
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Address Line | 202 8TH ST
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City | RADFORD
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State | VA
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Zip | 24141-2426
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Country | US
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Telephone | 540-639-5188
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Fax | 540-639-9215
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 27148
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 0101246067
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License Number State | VA
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