Individual
MRS. LISA M BAILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
7148 U S HIGHWAY 98, SUITE 101, HATTIESBURG, MS 39402-8577
(601) 261-1500
(601) 296-7549
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 261-1500
(601) 579-5240
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R669482
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00115017
—
MS
01
—
2283275
UNITED HEALTHCARE
MS
01
—
4846774
CIGNA
MS
01
—
7689898
AETNA
MS
Enumeration date
05/23/2006
Last updated
07/23/2020
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