| Doctor Name: | MRS. TERRICKA LATREASE BAILEY |
| NPI Number: | 1316307366 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN /APN |
| License Number: | 870475 |
| Business Practice Address: | 4250 Bethel Rd Olive Branch, MS - 386548737 |
| Business Phone Number: | 6629329440 |
| Business Fax Number: | |
| Mailing Address: | 2363 Linda Shore Dr, SOUTHAVEN |
| State: | MS |
| Postal Code: | 386728382 |
| Phone Number: | 6019551846 |
| Fax Number: | |
| NPI Enumeration Date: | 03/03/2016 |
| NPI Last Update Date: | 03/03/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2100X |
| License Number: | 870475 |
| 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: | |