Provider Demographics
NPI:1386306975
Name:HERRING, KATELYN BAILEY (FNP-BC)
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:BAILEY
Last Name:HERRING
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52184 HIGHWAY 25 S
Mailing Address - Street 2:
Mailing Address - City:AMORY
Mailing Address - State:MS
Mailing Address - Zip Code:38821-8691
Mailing Address - Country:US
Mailing Address - Phone:662-397-3811
Mailing Address - Fax:
Practice Address - Street 1:1208 GUY PICKLE RD
Practice Address - Street 2:
Practice Address - City:AMORY
Practice Address - State:MS
Practice Address - Zip Code:38821-8212
Practice Address - Country:US
Practice Address - Phone:662-256-3120
Practice Address - Fax:662-256-7092
Is Sole Proprietor?:No
Enumeration Date:2021-10-11
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS904887363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily