Individual
LORI BETH BAILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
4420 LAKE BOONE TRL, RALEIGH, NC 27607-7505
(919) 784-2676
Mailing address
101 KELLIE DR, SMITHFIELD, NC 27577-9443
(919) 938-3749
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
206739
NC
363L00000X
Nurse Practitioner
206739
NC
363LP0200X
Pediatric Nurse Practitioner
20103683
NC
363LP0200X
Pediatric Nurse Practitioner
206739
NC
363LP0200X
Pediatric Nurse Practitioner
Primary
5005364
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1174826952
—
NC
05
—
NP3248
—
SC
Enumeration date
12/16/2010
Last updated
05/27/2022
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