Individual
JENNIFER MICHELLE BAILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1701 N SENATE BLVD STE C-100, INDIANAPOLIS, IN 46202-1239
(317) 962-2390
(317) 963-5111
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28122960A
IN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
71009064A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001290179
ANTHEM PTAN
IN
05
—
300027712
—
IN
Enumeration date
06/14/2019
Last updated
05/09/2025
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