SUSAN EILEEN BAILEY (NPI# 1124540455) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124540455 |
| Entity Type | Individual |
| Full Name | SUSAN EILEEN BAILEY |
| Credential | APN-FNP |
| Practice Address |
6279 E State Blvd Fort Wayne IN 46815-7641 |
| Practice Telephone | 2604715521 |
| Mailing Telephone | 2602410993 |
| Enumeration Date | 2017-07-07 |
| Last Update Date | 2019-06-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
71007587 | IN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | CSR-PRESCRIPTIVE AUTHORITY | 71007587B | 01 |
| IN | APN PRESCRIPTIVE AUTHORITY LICENSE | 71007587 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144741042 | Susan Desiree Bailey | Licensed Practical Nurse | 1104 S Main St # A, Lexington, NC 27292-3134 | 2017-06-29 |
| 1326582321 | Susan Bailey | Registered Nurse | 806 Pearman Dairy Rd, Anderson, SC 29625-2616 | 2016-12-09 |
| 1164892394 | Susan Bailey | Nurse Practitioner | 4140 N 108th Ave, Suite 134, Phoenix, AZ 85037-5466 | 2015-09-30 |
| 1326393174 | Susan Bailey | Physical Therapist | 790 Roy Richard Dr., Schertz, TX 78154 | 2012-07-18 |
| 1780813360 | Susan E Bailey | Speech-Language Pathologist | 810 W Lamberth Rd, Sherman, TX 75092-2978 | 2009-07-05 |
| 1740430610 | Susan J Bailey | Counselor | Grove Street, 15 Grove Street, North Conway, NH 03860 | 2008-09-26 |
| 1568582062 | Susan Prange Bailey | Chiropractor | 664a Azalea Ave, Redding, CA 96002-0217 | 2007-03-29 |
| 1245358274 | Susan Lynn Bailey | Internal Medicine | 700 Commons Way, #227, Rochester, NY 14623-3147 | 2007-03-27 |
| 1245232016 | Susan Deborah Bailey | Nurse Practitioner | 863 3rd Ave N, St Petersburg, FL 33701-2703 | 2005-08-11 |
| 1174164115 | Susan A Bailey | Counselor | 116 Hills Plz, Charleston, WV 25387-2438 | 2019-10-01 |
| Street Address |
6279 E STATE BLVD |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46815-7641 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083903579 | Hook-superx, L.L.C. | Durable Medical Equipment & Medical Supplies | 6279 E State Blvd, Fort Wayne, IN 46815-7641 | 2011-04-05 |
| 1750871687 | Elgerene Monique Ridderheim | Nurse Practitioner | 6279 E State Blvd, Fort Wayne, IN 46815-7641 | 2018-05-16 |
| 1396151197 | Brenda Ann Anderson | Registered Nurse | 6279 E State Blvd, Fort Wayne, IN 46815-7641 | 2014-07-01 |
| 1093151466 | Sarah Elizabeth Huth | Nurse Practitioner | 6279 E State Blvd, Fort Wayne, IN 46815-7641 | 2013-05-13 |
| 1851643076 | Deidra Curry | Registered Nurse | 6279 E State Blvd, Fort Wayne, IN 46815 | 2012-10-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306305438 | Sullivan Services, Inc. | In Home Supportive Care | 2789-b Maplecrest Rd, Fort Wayne, IN 46815 | 2019-03-18 |
| 1598250144 | Altermease Gleason | Massage Therapist | 3406 Thames Drive, Fort Wayne, IN 46815 | 2018-06-26 |
| 1881000222 | Denise Sparks | Specialist | 6415 Benham Drive, Fort Wayne, IN 46815 | 2014-07-07 |
| 1962823138 | Chad Distelrath | Physical Therapy Assistant | 1717 Maplecrest Rd, Apt 112, Fort Wayne, IN 46815 | 2013-12-13 |
| 1689943409 | Kendall Joan Labrash | Physical Therapist | 4251 Lahmeyer Rd., Fort Wayne, IN 46815 | 2011-12-22 |
| 1801179718 | Jayson Laube | Pharmacist | 6201 Stellhorn, Fort Wayne, IN 46815 | 2011-09-27 |
| 1720294432 | Muscle Therapy Clinic LLC | Massage Therapist | 6409 Georgetown North Blvd, Fort Wayne, IN 46815 | 2007-05-16 |
| 1427186436 | Legoras Conture Fashions | Prosthetic/Orthotic Supplier | 3316 Inwood Drive, Fort Wayne, IN 46815 | 2007-03-01 |
| 1932252772 | Fort Wayne Smiles PC | Dentist | 2031 Reed Road, Fort Wayne, IN 46815 | 2007-01-18 |
| 1811078538 | Timothy Doody Lynch | Dentist | 4207 Hobson Court, Fort Wayne, IN 46815 | 2006-10-18 |
| Find all providers in zip 46815 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518566397 | Stacey Renee Pulver | Nurse Practitioner | 13134 Hollow Oak Rd, Fort Wayne, IN 46845-2327 | 2020-10-22 |
| 1649878554 | Heather Ormiston-leclear | Nurse Practitioner | 3800 N Anthony Blvd # Cc1335, Fort Wayne, IN 46805-1430 | 2020-10-13 |
| 1669081618 | Carly Ann Nahrwold | Nurse Practitioner | 7025 Old Trail Rd # 9574, Fort Wayne, IN 46809-2713 | 2020-07-27 |
| 1932725942 | Health Essential LLC | Nurse Practitioner | 3030 Lake Ave Ste 14, Fort Wayne, IN 46805-5428 | 2020-06-25 |
| 1942824842 | Carissa Miller | Nurse Practitioner | 707 Rollingwood Ln, Fort Wayne, IN 46845-1088 | 2020-06-05 |
| 1891329819 | Jasmine Monae Tubbs | Nurse Practitioner | 875 Petal Way, Fort Wayne, IN 46816-8900 | 2020-02-28 |
| 1235780362 | Elizabeth Rose Lichtsinn | Nurse Practitioner | 3919 W Jefferson Blvd Ste 200, Fort Wayne, IN 46804-6811 | 2019-09-20 |
| 1033676275 | Amanda Warner | Nurse Practitioner | 2229 Woods Rd, Fort Wayne, IN 46818-9539 | 2019-02-25 |
| 1669940714 | Brookelyn Agler | Nurse Practitioner | Summit Radiology, PC, 5001 Us Highway 30 W, Suite D, Fort Wayne, IN 46818-9701 | 2018-11-07 |
| 1346731908 | Erin Nicole Zimmerman | Nurse Practitioner | 10170 Illinois Rd # 14, Fort Wayne, IN 46804 | 2018-05-19 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46815 |
Please comment or provide details below to improve the information on SUSAN EILEEN BAILEY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.