Bahls, Vicki L

Bahls, Vicki L is an individual health care provider with primary practice located at 2518 E Dupont Rd , Fort Wayne IN 46825-1675. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Bahls, Vicki L can be contacted via phone (260) 432-4400.

Contact Information

Primary practice address
2518 E Dupont Rd Fort Wayne IN 46825-1675
Phone: (260) 432-4400
Fax: (260) 969-6898
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 28058063A Indiana
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 71000085 Indiana

Profile Details

NPI number 1619962198
LBN Legal business name Bahls, Vicki L
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 12th, 2005
Last updated Mar 5th, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619962198 NPPES
Indiana Other 500020063 RAIL ROAD MEDICARE
Indiana MEDICAID 200351030 RAIL ROAD MEDICARE

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