Individual
JOHN C BAILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
378 MARKETPLACE DR STE 5, JOHNSON CITY, TN 37604-2361
(423) 282-0751
(423) 282-1577
Mailing address
1019 W OAKLAND AVE, SUITE 1, JOHNSON CITY, TN 37604-2357
(423) 915-5000
(423) 915-5045
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APN07931
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1194781203
—
VA
01
—
P00435223
RAILROAD MEDICARE
TN
05
—
Q003282
—
TN
Enumeration date
04/26/2006
Last updated
06/05/2018
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