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Individual

SANDRA L BAILIFF

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNP

Contact information

Practice address
128 N WHITNEY AVE, COOKEVILLE, TN 38501-2493
(931) 783-4600
(931) 783-4699
Mailing address
140 W 7TH ST, COOKEVILLE, TN 38501-1726
(931) 783-5582
(931) 783-6760

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APN6537
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
PENDING
KY
05
PENDING
TN
Enumeration date
09/02/2005
Last updated
05/26/2022
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