Individual
MRS. JILL KENEDA BAILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN, BC
Contact information
Practice address
993 RITTER DR, BEAVER, WV 25813-9556
(304) 254-9330
(304) 254-9335
Mailing address
993 RITTER DR, BEAVER, WV 25813-9556
(304) 254-9330
(304) 254-9335
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
57720
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810009614
—
WV
Enumeration date
08/09/2007
Last updated
04/22/2008
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