Provider Demographics
NPI:1710785530
Name:BAILEY, KAREN PRYER
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:PRYER
Last Name:BAILEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4473 BLUE HERON WAY
Mailing Address - Street 2:
Mailing Address - City:BLADENSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20710-2400
Mailing Address - Country:US
Mailing Address - Phone:301-332-8551
Mailing Address - Fax:
Practice Address - Street 1:1401 DOWNING ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20018-3406
Practice Address - Country:US
Practice Address - Phone:202-629-2464
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-06
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC3747P1801XMedicaid