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General NPI Number Information
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NPI Number | 1598768947
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Entity Type | Individual
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Provider Name | JEFFREY P BAILEY CRNA
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Gender | Male
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Dates
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Enumeration Date | 05/31/2005
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Last Update Date | 03/31/2021
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Provider Practice Location Address
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Address Line | 1542 S BLOOMINGTON ST
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City | GREENCASTLE
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State | IN
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Zip | 46135-2212
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Country | US
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Telephone | 765-301-7617
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Fax |
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Provider Business Mailing Address
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Address Line | 8840 COMMERCE PARK PL STE E
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City | INDIANAPOLIS
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State | IN
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Zip | 46268-3129
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Country | US
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Telephone |
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | D-093513
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 28193939A
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License Number State | IN
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