Derrick Bailey

Individual provider Active NPI Family Nurse Practitioner · Andersen Afb, GU

NPI 1669929386 · NPPES record last updated Aug 16, 2023

Key facts

NPI
1669929386
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
APRN11003419 (FL)
Practice address
36 Medical Group
Andersen Afb, GU 96543-4010
Phone
(671) 366-3231
NPI assigned
Sep 11, 2016
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
RN 9369759FLMDRegistered Nurse
APRN11003419FLMDFamily Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN 9369759 FL
Family Nurse Practitioner 363LF0000X APRN11003419 FL Yes

Addresses

Primary practice location

36 Medical Group
Andersen Afb, GU 96543-4010

Mailing address

36 Medical Group
Unit 14010 Andersen Afb
Apo, AP 96543-4010
Phone (671) 366-3231

Other providers in Andersen Afb, GU

All providers in Andersen Afb, GU · Family Nurse Practitioner in Guam

Sources for this page

Verify at the official NPI Registry.