Individual
DOMINIQUE L BAILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
604A S 8TH ST, GRIFFIN, GA 30224-4214
(770) 227-1999
Mailing address
863 FLAT SHOALS RD SE STE 145, CONYERS, GA 30094-6633
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN227795
GA
Other
Enumeration date
05/18/2018
Last updated
02/21/2019
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