MEDICARE: NIA BAILEY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1164266979
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NIA BAILEY

Provider Business Mailing Address
First Line	:	901 TAMMY CIR
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45415-2136
Country	:	US
Telephone Number	:	937-397-4868
Fax Number	:

Provider Business Practice Location Address
First Line	:	1715 SPRINGFIELD ST
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45403-1431
Country	:	US
Telephone Number	:	937-838-4373
Fax Number	:	937-637-8385

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/25/2024
Last Update Date	:	06/25/2024

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Directions to “ NIA BAILEY ” Practice Location

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