Provider Demographics
NPI:1548889660
Name:BAILEY, SHERVON KATRINA (RN)
Entity type:Individual
Prefix:MS
First Name:SHERVON
Middle Name:KATRINA
Last Name:BAILEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5746 FRENCH CREEK CT
Mailing Address - Street 2:
Mailing Address - City:ELLENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34222-5202
Mailing Address - Country:US
Mailing Address - Phone:941-467-8025
Mailing Address - Fax:
Practice Address - Street 1:5746 FRENCH CREEK CT
Practice Address - Street 2:
Practice Address - City:ELLENTON
Practice Address - State:FL
Practice Address - Zip Code:34222-5202
Practice Address - Country:US
Practice Address - Phone:941-467-8025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-09
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9366739163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty