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General NPI Number Information
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NPI Number | 1417575788
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Entity Type | Individual
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Provider Name | BAILEY BOYD FNP
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Gender | Female
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Dates
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Enumeration Date | 07/13/2020
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Last Update Date | 06/19/2024
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Provider Practice Location Address
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Address Line | 350 S CHARLES G SEIVERS BLVD
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City | CLINTON
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State | TN
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Zip | 37716-3929
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Country | US
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Telephone | 865-290-2313
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Fax |
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Provider Business Mailing Address
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Address Line | 129 MEADOWOOD CIR
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City | LA FOLLETTE
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State | TN
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Zip | 37766-4540
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Country | US
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Telephone | 423-494-9803
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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 | APN0000029920
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License Number State | TN
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