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General NPI Number Information
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NPI Number | 1184297624
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Entity Type | Individual
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Provider Name | KYLE BAILEY
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Gender | Male
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Dates
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Enumeration Date | 07/22/2021
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Last Update Date | 12/07/2021
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Provider Practice Location Address
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Address Line | 7675 WELLNESS WAY
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City | WEST CHESTER
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State | OH
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Zip | 45069-2509
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Country | US
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Telephone | 513-475-8521
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Fax | 513-475-7480
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Provider Business Mailing Address
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Address Line | 947 VILLA DR
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City | VILLA HILLS
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State | KY
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Zip | 41017-3774
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Country | US
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Telephone | 185-975-0595
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | LE-00039231
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | APRNCNP0030384
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | RN.455460
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License Number State | OH
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