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General NPI Number Information
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NPI Number | 1063143329
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Entity Type | Individual
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Provider Name | JOHN ROBERT DEAN BAILEY APRN-CNP, FNP-BC
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Gender | Male
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Dates
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Enumeration Date | 06/17/2022
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Last Update Date | 10/26/2023
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Provider Practice Location Address
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Address Line | 1021 W COLLIN RAYE DR
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City | DE QUEEN
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State | AR
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Zip | 71832-2027
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Country | US
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Telephone | 870-518-0018
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Fax | 870-627-3532
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Provider Business Mailing Address
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Address Line | 1021 W COLLIN RAYE DR
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City | DE QUEEN
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State | AR
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Zip | 71832-2027
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Country | US
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Telephone | 870-518-0028
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 220804
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License Number State | AR
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