Individual
KHADIJAH BAILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1950 LEE RD STE 104, WINTER PARK, FL 32789-1847
(407) 956-1870
Mailing address
1950 LEE RD STE 104, WINTER PARK, FL 32789-1847
(407) 956-1870
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN5227701
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PN5227701
FLORIDA NURSING LICENSE
FL
Enumeration date
04/25/2019
Last updated
04/25/2019
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