Healthcare Provider Details

I. General information

NPI: 1215718291
Provider Name (Legal Business Name): ASHLEY BAILEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2023
Last Update Date: 12/02/2024
Certification Date: 12/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1815 W MARKET ST
AKRON OH
44313-7000
US

IV. Provider business mailing address

22423 FAIRLAWN CIR
FAIRVIEW PARK OH
44126-2203
US

V. Phone/Fax

Practice location:
  • Phone: 855-747-4673
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberCNP.0038179
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.501958
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: