Provider Demographics
NPI:1992343909
Name:CARMICHAEL, BAILLIE (NP-C)
Entity type:Individual
Prefix:
First Name:BAILLIE
Middle Name:
Last Name:CARMICHAEL
Suffix:
Gender:
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5615 S CHADWICK DR
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72758-8223
Mailing Address - Country:US
Mailing Address - Phone:479-659-4155
Mailing Address - Fax:
Practice Address - Street 1:5615 S CHADWICK DR
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-8223
Practice Address - Country:US
Practice Address - Phone:479-659-4155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-20
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR122656363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner