MEDICARE: BAILEY G. E. FITCH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LG0600X	Gerontology Nurse Practitioner	255797	SC

General Provider Information

NPI Number	:	1285567370
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BAILEY G. E. FITCH

Provider Business Mailing Address
First Line	:	116 OAKHURST DR
Second Line	:
City	:	NORTH AUGUSTA
State	:	SC
Zip	:	29860-9722
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	116 OAKHURST DR
Second Line	:
City	:	NORTH AUGUSTA
State	:	SC
Zip	:	29860-9722
Country	:	US
Telephone Number	:	803-530-5066
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2026
Last Update Date	:	06/08/2026

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