Connie Darlene Bagley, ARNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

17719 Issued in CA

Practice address

4652 Valle del Sol
Bonsall, CA 92003-5000

Phone

(760) 806-4870

Fax

(760) 806-4870

NPI assigned

Dec 16, 2006

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Specialist

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 25, 2016.

{
    "created_epoch": "1166227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458864000000",
    "number": "1336201052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4652 VALLE DEL SOL",
            "city": "BONSALL",
            "state": "CA",
            "postal_code": "920035000",
            "telephone_number": "760-806-4870",
            "fax_number": "760-806-4870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4652 VALLE DEL SOL",
            "city": "BONSALL",
            "state": "CA",
            "postal_code": "920035000",
            "telephone_number": "760-806-4870",
            "fax_number": "760-806-4870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAGLEY",
        "first_name": "CONNIE",
        "middle_name": "DARLENE",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-16",
        "last_updated": "2016-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "17719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• 24-7 Golden State Medi Trans. LLC
• Kayvon Adam Afsarifard
• Ginger Bahardar, LPCC LMFT
• Bonsall Unified School District
• Karen Boymoushakian, SLP CCC
• C. Greg Henderson DC Inc a Chiropractic Corporation
• Cardinal Medical Center, Inc

• All providers in Bonsall, CA
• Adult Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.