Provider Demographics
NPI:1538943915
Name:BAILEY, CHRISTIE LEE (NP)
Entity type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:LEE
Last Name:BAILEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:CHRISTIE
Other - Middle Name:LEE
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:310 N STATE OF FRANKLIN RD STE 202
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604-6063
Mailing Address - Country:US
Mailing Address - Phone:423-929-7111
Mailing Address - Fax:423-929-9448
Practice Address - Street 1:310 N STATE OF FRANKLIN RD STE 202
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-6063
Practice Address - Country:US
Practice Address - Phone:423-929-7111
Practice Address - Fax:423-929-9448
Is Sole Proprietor?:No
Enumeration Date:2023-08-24
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN34178363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner