Provider Demographics
NPI:1144813403
Name:BAILEY, JANSSEN SHEA (APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:JANSSEN
Middle Name:SHEA
Last Name:BAILEY
Suffix:
Gender:F
Credentials:APRN, FNP-C
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Mailing Address - Street 1:2605 KENTUCKY AVENUE
Mailing Address - Street 2:MEDICAL PARK 3 SUITE 404
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42001-7533
Mailing Address - Country:US
Mailing Address - Phone:270-356-4115
Mailing Address - Fax:
Practice Address - Street 1:2605 KENTUCKY AVENUE
Practice Address - Street 2:MEDICAL PARK 3 SUITE 404
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42001-7533
Practice Address - Country:US
Practice Address - Phone:270-356-4115
Practice Address - Fax:270-356-4116
Is Sole Proprietor?:No
Enumeration Date:2021-02-18
Last Update Date:2025-05-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY3015704363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY3015704OtherSTATE LICENSE