Individual
MR. JONNATHAN E. BAILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
306 STANAFORD RD, BECKLEY, WV 25801-3142
(304) 255-3000
(606) 574-8013
Mailing address
81 BALL PARK RD, HARLAN, KY 40831-1701
(606) 574-8425
(606) 574-8013
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
071742
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810001000
—
WV
Enumeration date
07/20/2005
Last updated
07/08/2007
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