Provider Demographics
NPI:1831060946
Name:BAILEY, ADDISON ELAINE
Entity type:Individual
Prefix:MRS
First Name:ADDISON
Middle Name:ELAINE
Last Name:BAILEY
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:ADDISON
Other - Middle Name:ELAINE
Other - Last Name:ABORN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3442 LONGLEAF AVE
Mailing Address - Street 2:
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45430-1453
Mailing Address - Country:US
Mailing Address - Phone:813-708-2165
Mailing Address - Fax:
Practice Address - Street 1:3442 LONGLEAF AVE
Practice Address - Street 2:
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45430-1453
Practice Address - Country:US
Practice Address - Phone:813-708-2165
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-13
Last Update Date:2025-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty