Provider Demographics
NPI:1568972214
Name:BAILEY, JILL NEWKIRK (PT, DPT)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:NEWKIRK
Last Name:BAILEY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 34669
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68134-0669
Mailing Address - Country:US
Mailing Address - Phone:402-932-6791
Mailing Address - Fax:
Practice Address - Street 1:6307 CENTER ST STE B
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68106-3458
Practice Address - Country:US
Practice Address - Phone:402-884-7453
Practice Address - Fax:402-884-5983
Is Sole Proprietor?:No
Enumeration Date:2017-10-09
Last Update Date:2017-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2178225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist