Provider Demographics
NPI:1316912587
Name:BAILEY, CATHERINE JANE (PA-C)
Entity type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:JANE
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 1:4800 BELFORT RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-6004
Mailing Address - Country:US
Mailing Address - Phone:904-398-7205
Mailing Address - Fax:904-396-4047
Practice Address - Street 1:4800 BELFORT RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-6004
Practice Address - Country:US
Practice Address - Phone:904-398-7205
Practice Address - Fax:904-396-4047
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9103086363AM0700X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA163842428AMedicaid
GAP00662708OtherRAILROAD MEDICARE
FL291987700Medicaid
FL291987700Medicaid
FLU5983YMedicare PIN
GA163842428AMedicaid