Provider Demographics
NPI:1174749121
Name:BAILEY, B JOANNE (CRNA)
Entity type:Individual
Prefix:MRS
First Name:B
Middle Name:JOANNE
Last Name:BAILEY
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:BETTY
Other - Middle Name:JO
Other - Last Name:STEVENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:PO BOX 141
Mailing Address - Street 2:HOUSE # B 17
Mailing Address - City:CANNELTON
Mailing Address - State:WV
Mailing Address - Zip Code:25036
Mailing Address - Country:US
Mailing Address - Phone:304-442-8316
Mailing Address - Fax:
Practice Address - Street 1:1325 LOCUST AVE
Practice Address - Street 2:FAIRMONT GENERAL HOSPITAL
Practice Address - City:FAIRMONT
Practice Address - State:WV
Practice Address - Zip Code:26554
Practice Address - Country:US
Practice Address - Phone:304-367-7371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2025-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV10927163W00000X
WV21534367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0066547000Medicare ID - Type Unspecified