Healthcare Provider Details

I. General information

NPI: 1063377182
Provider Name (Legal Business Name): ASHLEY ELITA BAILEY PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2025
Last Update Date: 03/18/2026
Certification Date: 03/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2502 MOUNT MORIAH RD STE H231
MEMPHIS TN
38115-1515
US

IV. Provider business mailing address

2502 MOUNT MORIAH RD STE H231 PMB 1098
MEMPHIS TN
38115-1515
US

V. Phone/Fax

Practice location:
  • Phone: 901-215-8494
  • Fax:
Mailing address:
  • Phone: 901-215-8494
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number40765
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: