Whitney Bailey
Individual provider Active NPI Contractor · Horn Lake, MS
NPI 1811640352 · NPPES record last updated Feb 3, 2022
Key facts
- NPI
- 1811640352
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Contractor 171W00000X
- Practice address
- 5551 Port Stacy Dr
Horn Lake, MS 38637-4405 - Phone
- (901) 355-9733
- NPI assigned
- Feb 3, 2022
- 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | Yes |
Addresses
Primary practice location
5551 Port Stacy Dr
Horn Lake, MS 38637-4405
Mailing address
5551 Port Stacy Dr
Horn Lake, MS 38637-4405
Phone (901) 355-9733
Other providers in Horn Lake, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 3, 2022. 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.