Individual provider · NPI-1

Lara Tripoli Bailey, FNP

Nurse Practitioner · Palm Coast, FL

NPI number1942551155
StatusActive
Last updated in NPPESFeb 26, 2024

Details

NPI
1942551155
Entity type
Individual (NPI-1)
Name
Mrs. Lara Tripoli Bailey
Credential
FNP
Sex
Female
Sole proprietor
Yes
Enumeration date
Sep 27, 2012
Certification date
Feb 26, 2024
Last updated
Feb 26, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363L00000X Nurse Practitioner11020883FLYes

Practice location

52 Forest Grove Dr
Palm Coast, FL 32137-9101

Phone 860-819-7917

Mailing address

52 Forest Grove Dr
Palm Coast, FL 32137-9101

Phone 860-819-7917

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