Individual
ANIETRA DENEEN LASHAWN BAILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3614 PROVIDENCE RD S STE 200, WAXHAW, NC 28173-6310
(704) 384-8640
(704) 384-8650
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2023-01046
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/08/2019
Last updated
09/20/2023
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