MEDICARE: MRS. BAILEY CHANLEY PMHNP-BC

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	71017449A	IN
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	G187472	IA

General Provider Information

NPI Number	:	1235005323
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. BAILEY CHANLEY PMHNP-BC

Provider Business Mailing Address
First Line	:	423 N 3RD ST
Second Line	:
City	:	VINCENNES
State	:	IN
Zip	:	47591-1312
Country	:	US
Telephone Number	:
Fax Number	:	812-916-9335

Provider Business Practice Location Address
First Line	:	1351 W BUENA VISTA RD
Second Line	:
City	:	EVANSVILLE
State	:	IN
Zip	:	47710-3338
Country	:	US
Telephone Number	:	833-659-4357
Fax Number	:	812-916-9335

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

Provider Enumeration Date	:	10/15/2025
Last Update Date	:	02/16/2026

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