Provider Demographics
NPI:1215816434
Name:BAILEY, JADA DAWN (PA-C)
Entity type:Individual
Prefix:
First Name:JADA
Middle Name:DAWN
Last Name:BAILEY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:JADA
Other - Middle Name:DAWN
Other - Last Name:BAILEY-CLYBURN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:323 WINTER QUARTERS DR
Mailing Address - Street 2:
Mailing Address - City:POCOMOKE CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21851-1044
Mailing Address - Country:US
Mailing Address - Phone:410-603-6433
Mailing Address - Fax:
Practice Address - Street 1:12302 SOMERSET AVE STE A
Practice Address - Street 2:
Practice Address - City:PRINCESS ANNE
Practice Address - State:MD
Practice Address - Zip Code:21853-3099
Practice Address - Country:US
Practice Address - Phone:410-651-0300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-01
Last Update Date:2025-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0010121363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty