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General NPI Number Information
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NPI Number | 1548089832
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Entity Type | Individual
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Provider Name | BAILEY LOGAN MUSICK FNP
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Gender | Male
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Dates
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Enumeration Date | 10/04/2024
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Last Update Date | 11/20/2024
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Provider Practice Location Address
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Address Line | 641 CAMPUS DRIVE STE A
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City | ABINGDON
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State | VA
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Zip | 24210
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Country | US
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Telephone | 276-676-3870
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 9
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City | KINGSPORT
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State | TN
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Zip | 37662-0009
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Country | US
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Telephone |
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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 | 37287
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0024191570
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License Number State | VA
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