Individual
MS. MAUREEN BAILEY-NUTTING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1028 N CHURCH ST, GREENVILLE, SC 29601-1639
(864) 271-1464
(864) 467-9119
Mailing address
PO BOX 743294, ATLANTA, GA 30374-3294
(864) 271-1464
(864) 467-9119
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1097
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1049253
NCCPA
SC
01
—
1097
STATE MEDICAL LICENSE NUMBER
SC
01
—
1699775882
NPI NUMBER
—
Enumeration date
07/28/2005
Last updated
06/07/2016
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