Individual
MISS JENNIFER DIANE BAILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
12TH STREET EXT, PRINCETON, WV 24740
(304) 487-7286
(304) 487-7132
Mailing address
PO BOX 2022, PRINCETON, WV 24740-4922
(304) 487-7265
(304) 487-7132
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
4390
WV
183500000X
Pharmacist
8090
VA
183500000X
Pharmacist
9101
NC
Other
Enumeration date
05/22/2007
Last updated
07/08/2007
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