Provider Demographics
NPI:1386385425
Name:BAILEY, ALLYSON N (PA)
Entity type:Individual
Prefix:
First Name:ALLYSON
Middle Name:N
Last Name:BAILEY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:880 KEMPSVILLE RD STE 101
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-3957
Mailing Address - Country:US
Mailing Address - Phone:757-466-6350
Mailing Address - Fax:
Practice Address - Street 1:880 KEMPSVILLE RD STE 101
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-3957
Practice Address - Country:US
Practice Address - Phone:757-466-6350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-05
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110008517363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant