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General NPI Number Information
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NPI Number | 1902719552
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Entity Type | Individual
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Provider Name | BAILEY NICHOLSON
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Gender | Female
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Dates
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Enumeration Date | 09/24/2026
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Last Update Date | 09/24/2026
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Provider Practice Location Address
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Address Line | 1441 HIGHWAY 62 412
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City | HIGHLAND
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State | AR
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Zip | 72542-9497
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Country | US
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Telephone | 870-955-1020
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Fax | 870-277-0896
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Provider Business Mailing Address
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Address Line | 306 E MAIN ST
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City | ASH FLAT
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State | AR
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Zip | 72513-8008
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | OTA2243
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License Number State | AR
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