Basic Information
| Provider Information | |||||||||
| NPI: | 1447892872 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BAILEY | ||||||||
| FirstName: | KATIE | ||||||||
| MiddleName: | L. | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 535 MAIN ST STE 1 | ||||||||
| Address2: | |||||||||
| City: | OLEAN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 147601593 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7163720141 | ||||||||
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| Practice Location | |||||||||
| Address1: | 12 S MAIN ST | ||||||||
| Address2: | |||||||||
| City: | FRANKLINVILLE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 147371224 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7166762212 | ||||||||
| FaxNumber: | 7166762432 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/17/2019 | ||||||||
| LastUpdateDate: | 06/05/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/05/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207QA0505X | 309418 | NY | Y | Allopathic & Osteopathic Physicians | Family Medicine | Adult Medicine |
No ID Information.