Provider Demographics
NPI:1124741046
Name:BAHL, AMY J (CRNP)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:J
Last Name:BAHL
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1 LECOM PL
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16505-2571
Mailing Address - Country:US
Mailing Address - Phone:814-868-2529
Mailing Address - Fax:814-868-2522
Practice Address - Street 1:965 SHAMROCK LN
Practice Address - Street 2:
Practice Address - City:CORRY
Practice Address - State:PA
Practice Address - Zip Code:16407-1196
Practice Address - Country:US
Practice Address - Phone:814-665-8288
Practice Address - Fax:814-664-8618
Is Sole Proprietor?:No
Enumeration Date:2022-09-26
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PARN626746163WG0000X
PASP026346363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice