Kimberly Bailey
Individual provider Active NPI Primary Care Clinic/Center · Fort Campbell, KY
NPI 1104062587 · NPPES record last updated Jan 6, 2009
Key facts
- NPI
- 1104062587
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Primary Care Clinic/Center 261QP2300X
- License
- 149914 (TN)
- Practice address
- 650 Joel Dr
Fort Campbell, KY 42223-5318 - Phone
- (270) 789-8400
- Fax
- (270) 956-0756
- NPI assigned
- Jan 6, 2009
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 149914 | TN | MD | Primary Care Clinic/Center |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | 149914 | TN | Yes |
Addresses
Primary practice location
650 Joel Dr
Fort Campbell, KY 42223-5318
Mailing address
650 Joel Dr
Fort Campbell, KY 42223-5318
Phone (270) 789-8400
Other providers in Fort Campbell, KY
- Jamie L Back
- Ferdinand K. Bacomo
- Laura Lesa Bacon
- Marianne Bae
- Jennifer R Baggett
- Shawn M Bailey
- Gena Baisa
- Michael Robert Baker
- Pamela Jane Baker
- John David Baldwin
All providers in Fort Campbell, KY · Primary Care Clinic/Center in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 6, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.