Provider Demographics
NPI:1255136768
Name:DEAN, BAILEY ASH
Entity type:Individual
Prefix:
First Name:BAILEY
Middle Name:ASH
Last Name:DEAN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5789 WEST HIGHWAY 20, PO BOX 900, CHADRON, NE 69337
Mailing Address - Street 2:
Mailing Address - City:CHADRON
Mailing Address - State:NE
Mailing Address - Zip Code:69337
Mailing Address - Country:US
Mailing Address - Phone:308-432-4050
Mailing Address - Fax:
Practice Address - Street 1:5789 WEST HIGHWAY 20, PO BOX 900, CHADRON, NE 69337
Practice Address - Street 2:
Practice Address - City:CHADRON
Practice Address - State:NE
Practice Address - Zip Code:69337
Practice Address - Country:US
Practice Address - Phone:308-432-4050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-18
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker