Provider Demographics
NPI:1124076781
Name:BAILEY, ERIN ELIZABETH (PA-C)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:ELIZABETH
Last Name:BAILEY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8921 THREE CHOPT RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23229-4601
Mailing Address - Country:US
Mailing Address - Phone:804-285-9416
Mailing Address - Fax:804-285-9461
Practice Address - Street 1:8921 THREE CHOPT RD
Practice Address - Street 2:SUITE 300
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23229-4601
Practice Address - Country:US
Practice Address - Phone:804-285-9416
Practice Address - Fax:804-285-9461
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2015-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110001897363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q24594Medicare UPIN
005467R66Medicare ID - Type Unspecified