Basic Information
Provider Information
NPI: 1225680051
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BAILEY
FirstName: ASHLEIGH
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: CRNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 785 5TH AVE STE 3
Address2:  
City: CHAMBERSBURG
State: PA
PostalCode: 172014232
CountryCode: US
TelephoneNumber: 7172639555
FaxNumber: 7177096529
Practice Location
Address1: 601 E MAIN ST
Address2:  
City: WAYNESBORO
State: PA
PostalCode: 172682332
CountryCode: US
TelephoneNumber: 7177655088
FaxNumber: 7177655066
Other Information
ProviderEnumerationDate: 07/11/2019
LastUpdateDate: 08/18/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/18/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XSP020471PAN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
363L00000XSP020471PAY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

ID Information
IDTypeStateIssuerDescription
10367245705PA MEDICAID
1450155901PACAQHOTHER


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