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General NPI Number Information
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NPI Number | 1750638037
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Entity Type | Individual
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Provider Name | BEATRICE LYNETTE BAILEY NP-C
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Gender | Female
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Dates
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Enumeration Date | 08/06/2012
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Last Update Date | 10/31/2013
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Provider Practice Location Address
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Address Line | 249 E HIGHLAND AVE
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City | SAN BERNARDINO
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State | CA
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Zip | 92404-3707
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Country | US
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Telephone | 909-881-1683
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Fax | 909-881-4215
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Provider Business Mailing Address
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Address Line | 25740 MESA CT
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City | SAN BERNARDINO
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State | CA
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Zip | 92404-3074
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Country | US
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Telephone | 909-881-1683
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Fax | 909-881-4215
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | F0712247
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License Number State | MS
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