Provider Demographics
NPI:1306674486
Name:BAILEY, THOMASINA L (NP)
Entity type:Individual
Prefix:
First Name:THOMASINA
Middle Name:L
Last Name:BAILEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:THOMASINA
Other - Middle Name:L
Other - Last Name:MCALLISTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:115 AL ROBERTS RD
Mailing Address - Street 2:
Mailing Address - City:SENOIA
Mailing Address - State:GA
Mailing Address - Zip Code:30276-3556
Mailing Address - Country:US
Mailing Address - Phone:912-381-2885
Mailing Address - Fax:
Practice Address - Street 1:1975 HIGHWAY 54 W STE 150
Practice Address - Street 2:
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-4795
Practice Address - Country:US
Practice Address - Phone:770-486-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-22
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN224518363LF0000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine