Provider Demographics
NPI:1346758141
Name:BAILEY, REBECCA JEAN
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:JEAN
Last Name:BAILEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7621 OSCAR LONG RD
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47141-9803
Mailing Address - Country:US
Mailing Address - Phone:812-786-6191
Mailing Address - Fax:
Practice Address - Street 1:7621 OSCAR LONG RD
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47141-9803
Practice Address - Country:US
Practice Address - Phone:812-786-6191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-15
Last Update Date:2018-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)