Provider Demographics
NPI:1013356799
Name:BAILEY, NICHOLAS ALAN (AUD)
Entity Type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:ALAN
Last Name:BAILEY
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2298 OCEAN HWY W # 17
Mailing Address - Street 2:
Mailing Address - City:SUPPLY
Mailing Address - State:NC
Mailing Address - Zip Code:28462-4024
Mailing Address - Country:US
Mailing Address - Phone:910-755-2428
Mailing Address - Fax:
Practice Address - Street 1:2298 OCEAN HWY W # 17
Practice Address - Street 2:
Practice Address - City:SUPPLY
Practice Address - State:NC
Practice Address - Zip Code:28462-4024
Practice Address - Country:US
Practice Address - Phone:910-755-2428
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-17
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10964231H00000X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter