Provider Demographics
NPI:1316197882
Name:BAILEY, DELL BARKER (CRNA)
Entity type:Individual
Prefix:
First Name:DELL
Middle Name:BARKER
Last Name:BAILEY
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5059
Mailing Address - Street 2:
Mailing Address - City:OAK RIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37831-5059
Mailing Address - Country:US
Mailing Address - Phone:800-611-6713
Mailing Address - Fax:770-237-7346
Practice Address - Street 1:990 OAK RIDGE TPKE
Practice Address - Street 2:ANESTHESIA DEPARTMENT
Practice Address - City:OAK RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37830-6976
Practice Address - Country:US
Practice Address - Phone:865-483-7498
Practice Address - Fax:770-237-7346
Is Sole Proprietor?:No
Enumeration Date:2008-09-22
Last Update Date:2009-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000013679367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3600421Medicaid
TN4212233OtherBLUE CROSS BLUE SHIELD OF TN
TN3600421Medicare PIN