MEDICARE: JACQUELINE G BAILEY APRN-CNP

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	363L00000X	Nurse Practitioner	APRN.CNP.024795	OH
2	363LF0000X	Family Nurse Practitioner	APRN.CNP.024795	OH

General Provider Information

NPI Number	:	1780248443
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACQUELINE G BAILEY APRN-CNP

Provider Business Mailing Address
First Line	:	700 ACKERMAN RD STE 2120
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43202-1559
Country	:	US
Telephone Number	:	614-293-5123
Fax Number	:	614-293-4980

Provider Business Practice Location Address
First Line	:	1800 ZOLLINGER RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43221-2849
Country	:	US
Telephone Number	:	614-293-5123
Fax Number	:	614-293-4890

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

Provider Enumeration Date	:	04/29/2019
Last Update Date	:	01/20/2026

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