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NPI Code Detail

MEDICARE: JOHN ROBERT DEAN BAILEY APRN-CNP, FNP-BC

MEDICARE: JOHN ROBERT DEAN BAILEY APRN-CNP, FNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner220804AR

General Provider Information

NPI Number : 1063143329
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN ROBERT DEAN BAILEY APRN-CNP, FNP-BC
Provider Business Mailing Address
First Line : 3515 RICHMOND RD
Second Line :
City : TEXARKANA
State : TX
Zip : 75503-0711
Country : US
Telephone Number : 903-791-9355
Fax Number : 903-831-7258
Provider Business Practice Location Address
First Line : 3515 RICHMOND RD
Second Line :
City : TEXARKANA
State : TX
Zip : 75503-0711
Country : US
Telephone Number : 903-791-9355
Fax Number : 903-831-7258
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2022
Last Update Date : 06/20/2026

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