Provider Demographics
NPI:1306583547
Name:BAILEY, ANNIE F (PA-C)
Entity type:Individual
Prefix:
First Name:ANNIE
Middle Name:F
Last Name:BAILEY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ANNIE
Other - Middle Name:F
Other - Last Name:CAMPBELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:700 GERMAN ST
Mailing Address - Street 2:
Mailing Address - City:TAWAS CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48763-9349
Mailing Address - Country:US
Mailing Address - Phone:989-362-4170
Mailing Address - Fax:989-362-0034
Practice Address - Street 1:700 GERMAN ST
Practice Address - Street 2:
Practice Address - City:TAWAS CITY
Practice Address - State:MI
Practice Address - Zip Code:48763-9349
Practice Address - Country:US
Practice Address - Phone:989-362-4170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-18
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant