Provider Demographics
NPI:1528781879
Name:PHILLIPS, BAILEY CASSANDRA (CRNP)
Entity type:Individual
Prefix:
First Name:BAILEY
Middle Name:CASSANDRA
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:231 LEBANON MANOR DR
Mailing Address - Street 2:
Mailing Address - City:WEST MIFFLIN
Mailing Address - State:PA
Mailing Address - Zip Code:15122-3218
Mailing Address - Country:US
Mailing Address - Phone:724-889-5368
Mailing Address - Fax:
Practice Address - Street 1:1515 LOCUST ST FL 5
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15219-5131
Practice Address - Country:US
Practice Address - Phone:412-232-8888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-21
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP026051363LF0000X
PARN707603163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
PASP026051OtherCERTIFIED REGISTERED NURSE PRACTITIONER(FAMILY HEALTH)
PARN707603OtherREGISTERED NURSE