Provider Demographics
NPI:1154139632
Name:BAILEY, WENDY MARIE (CCHW)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:MARIE
Last Name:BAILEY
Suffix:
Gender:F
Credentials:CCHW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 10TH ST NW
Mailing Address - Street 2:
Mailing Address - City:LINTON
Mailing Address - State:IN
Mailing Address - Zip Code:47441-5652
Mailing Address - Country:US
Mailing Address - Phone:812-798-0058
Mailing Address - Fax:
Practice Address - Street 1:455 10TH ST NW
Practice Address - Street 2:
Practice Address - City:LINTON
Practice Address - State:IN
Practice Address - Zip Code:47441-5652
Practice Address - Country:US
Practice Address - Phone:812-798-0058
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-30
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker