Jennifer Olivia Bailey
Individual provider Active NPI Nurse's Aide · Bethlehem, GA
NPI 1124873138 · NPPES record last updated Apr 22, 2024
Key facts
- NPI
- 1124873138
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse's Aide 376K00000X
- License
- CN0014221468 (GA)
- Practice address
- 2331 Foxy Dr
Bethlehem, GA 30620-7666 - Phone
- (678) 227-3384
- NPI assigned
- Apr 22, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
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 |
|---|---|---|---|
| CN0014221468 | GA | MD | Nurse's Aide |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Blossom Private Duty Care LLC | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse's Aide | 376K00000X | CN0014221468 | GA | Yes |
Addresses
Primary practice location
2331 Foxy Dr
Bethlehem, GA 30620-7666
Mailing address
2331 Foxy Dr
Bethlehem, GA 30620-7666
Phone (678) 227-3384
Other providers in Bethlehem, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 22, 2024. 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.