Provider Demographics
NPI:1881398329
Name:CLAPPER, BAILEY (MAT, LAT, ATC)
Entity type:Individual
Prefix:
First Name:BAILEY
Middle Name:
Last Name:CLAPPER
Suffix:
Gender:F
Credentials:MAT, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 N 20TH ST APT 533
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68102-4320
Mailing Address - Country:US
Mailing Address - Phone:402-320-4878
Mailing Address - Fax:
Practice Address - Street 1:900 WOODBURY AVE STE 9
Practice Address - Street 2:
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51503-7855
Practice Address - Country:US
Practice Address - Phone:712-328-8301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-29
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE11032255A2300X
IA1147382255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer