Benny Bailey

Individual provider Active NPI Psychiatric/Mental Health Registered Nurse · Louisa, KY

NPI 1083176713 · NPPES record last updated Aug 15, 2024

Key facts

NPI
1083176713
Entity type
Individual (NPI type 1)
Primary specialty
Psychiatric/Mental Health Registered Nurse 163WP0808X
License
1155177 (KY)
Practice address
60 Professional Park Dr
Louisa, KY 41230-9644
Phone
(606) 638-4332
NPI assigned
Apr 2, 2019
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
1155177KYMDPsychiatric/Mental Health Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 1155177 KY Yes
Registered Nurse 163W00000X 1155177 KY

Addresses

Primary practice location

60 Professional Park Dr
Louisa, KY 41230-9644

Mailing address

PO Box 790
Ashland, KY 41105-0790
Phone (606) 329-8588

Other practice location 1

3701 Landsdowne Dr
Ashland, KY 41102-5422
Phone (606) 324-3005

Other providers in Louisa, KY

All providers in Louisa, KY · Psychiatric/Mental Health Registered Nurse in Kentucky

Sources for this page

Verify at the official NPI Registry.