Individual
KRISTOPHER A BAILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
8200 MILE TREE DR, FORT SMITH, AR 72903-4373
(479) 926-9089
Mailing address
PO BOX 10911, FORT SMITH, AR 72917-0911
(479) 926-9089
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R52454
AR
367500000X
Certified Registered Nurse Anesthetist
Primary
C01305
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
163947001
—
AR
05
—
200099290A
—
OK
01
—
5A131
BC/BS OF AR
AR
Enumeration date
10/27/2006
Last updated
01/12/2017
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