Provider Demographics
NPI:1538309323
Name:BAILEY, PATRICIA D (CNP)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:D
Last Name:BAILEY
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:D
Other - Last Name:MASON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNP
Mailing Address - Street 1:20 S 3RD ST STE 210
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-4206
Mailing Address - Country:US
Mailing Address - Phone:614-296-4941
Mailing Address - Fax:
Practice Address - Street 1:20 S 3RD ST STE 210
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-4206
Practice Address - Country:US
Practice Address - Phone:614-296-4941
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-06
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN110208032084P0800X
OHRN.306137163W00000X
VA00241832702084P0800X
MN57642084P0800X
NM669682084P0800X
SDCP0012492084P0800X
OHNP.10555363LF0000X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1174168843Medicaid