Provider Demographics
NPI:1689497596
Name:BAILEY, TAYLOR (FNP-C)
Entity type:Individual
Prefix:DR
First Name:TAYLOR
Middle Name:
Last Name:BAILEY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5458 ACCESS RD
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45431-1405
Mailing Address - Country:US
Mailing Address - Phone:919-812-0930
Mailing Address - Fax:
Practice Address - Street 1:3286 PENTAGON BLVD UNIT 10
Practice Address - Street 2:
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45431-1789
Practice Address - Country:US
Practice Address - Phone:937-490-6511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-07
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHF11240113363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner