Provider Demographics
NPI:1871870394
Name:BAILEY, CARY ANN (MSN, ACNP-BC)
Entity type:Individual
Prefix:MRS
First Name:CARY
Middle Name:ANN
Last Name:BAILEY
Suffix:
Gender:F
Credentials:MSN, ACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 W COMMERCIAL DR STE H
Mailing Address - Street 2:
Mailing Address - City:CARTERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62918-2057
Mailing Address - Country:US
Mailing Address - Phone:618-985-9559
Mailing Address - Fax:618-985-9005
Practice Address - Street 1:209 W COMMERCIAL DR STE H
Practice Address - Street 2:
Practice Address - City:CARTERVILLE
Practice Address - State:IL
Practice Address - Zip Code:62918-2057
Practice Address - Country:US
Practice Address - Phone:618-985-9559
Practice Address - Fax:618-985-9005
Is Sole Proprietor?:No
Enumeration Date:2011-11-11
Last Update Date:2017-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209009211363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care