Individual
JEFFREY P BAILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1542 S BLOOMINGTON ST, GREENCASTLE, IN 46135-2212
(765) 301-7617
Mailing address
8840 COMMERCE PARK PL STE E, INDIANAPOLIS, IN 46268-3129
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
28193939A
IN
367500000X
Certified Registered Nurse Anesthetist
D-093513
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0237735
—
IA
05
—
201001060
—
IN
01
—
42027
BCBS PROVIDER #
IA
Enumeration date
05/31/2005
Last updated
03/31/2021
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