Provider Demographics
NPI:1023635265
Name:BAILEY, BRITTANY SHARP
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:SHARP
Last Name:BAILEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5757 ACCOMAC SQ
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BCH
Mailing Address - State:VA
Mailing Address - Zip Code:23455-2348
Mailing Address - Country:US
Mailing Address - Phone:931-797-5498
Mailing Address - Fax:
Practice Address - Street 1:5757 ACCOMAC SQ
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23455-2348
Practice Address - Country:US
Practice Address - Phone:931-797-5498
Practice Address - Fax:183-345-6912
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-04
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered