MEDICARE: KENDRA BAILY AUD

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
1	231H00000X	Audiologist

General Provider Information

NPI Number	:	1720428493
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENDRA BAILY AUD

Provider Business Mailing Address
First Line	:	1000 W 4TH ST STE 8
Second Line	:
City	:	YANKTON
State	:	SD
Zip	:	57078-3700
Country	:	US
Telephone Number	:	605-655-1220
Fax Number	:

Provider Business Practice Location Address
First Line	:	409 SUMMIT ST STE 2800
Second Line	:
City	:	YANKTON
State	:	SD
Zip	:	57078-3735
Country	:	US
Telephone Number	:	605-655-1220
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/26/2013
Last Update Date	:	11/29/2017

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Directions to “ KENDRA BAILY AUD” Practice Location

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