Individual
CHARISMA BAILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
310 N STATE OF FRANKLIN RD STE 400, JOHNSON CITY, TN 37604-6051
(423) 979-6000
Mailing address
1021 W OAKLAND AVE STE 310, JOHNSON CITY, TN 37604-2192
(423) 302-6565
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0024171841
VA
363LF0000X
Family Nurse Practitioner
18986
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1801200506
—
NC
05
—
1801200506
—
VA
05
—
7100302680
—
KY
01
—
P01505609
RAILROAD MEDICARE
TN
01
—
P01673823
RAILROAD MEDICARE
VA
05
—
Q006912
—
TN
Enumeration date
06/20/2014
Last updated
06/06/2024
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