Doctor Name: | MRS. ELIZABETH EWING BAILEY |
NPI Number: | 1013941970 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ACNP |
License Number: | R873439 |
Business Practice Address: | 499 Gloster Creek Vlg Ste A2 Suite A-2 Tupelo, MS - 388014749 |
Business Phone Number: | 6626206800 |
Business Fax Number: | 6626206950 |
Mailing Address: | 499 Gloster Creek Vlg Ste A2, Suite A-2 TUPELO |
State: | MS |
Postal Code: | 388014749 |
Phone Number: | 6626206800 |
Fax Number: | 6626206950 |
NPI Enumeration Date: | 07/10/2006 |
NPI Last Update Date: | 03/03/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2100X |
License Number: | R873439 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MS |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Acute Care |
Taxonomy Definition: |