Provider Demographics
NPI:1609488527
Name:BAILEY, KIMBERLY JUNE
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:JUNE
Last Name:BAILEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 608
Mailing Address - Street 2:
Mailing Address - City:CEREDO
Mailing Address - State:WV
Mailing Address - Zip Code:25507-0608
Mailing Address - Country:US
Mailing Address - Phone:304-881-7235
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 608
Practice Address - Street 2:
Practice Address - City:CEREDO
Practice Address - State:WV
Practice Address - Zip Code:25507-0608
Practice Address - Country:US
Practice Address - Phone:304-881-7235
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-21
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant