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Individual

PAMELA RAE BAILEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2106-A LOOP ROAD, WIINNSBORO, LA 71295
(318) 435-6363
(318) 435-4646
Mailing address
116 JACK JONES RD, WINNSBORO, LA 71295-6616

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
RN-114742-AP06631
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2169904
LA
Enumeration date
08/16/2011
Last updated
06/18/2013
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