Provider Demographics
NPI:1770051708
Name:MCCARLEY, BAILEE VERNON (FNP)
Entity type:Individual
Prefix:MRS
First Name:BAILEE
Middle Name:VERNON
Last Name:MCCARLEY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92-553 AKAAWA ST
Mailing Address - Street 2:
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707-1028
Mailing Address - Country:US
Mailing Address - Phone:864-933-7895
Mailing Address - Fax:
Practice Address - Street 1:4211 WAIALAE AVE # 9220
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-5319
Practice Address - Country:US
Practice Address - Phone:808-732-0782
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-07
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI3556363L00000X
SC22050363LX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0106XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerOccupational Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner