Provider Demographics
NPI:1326885781
Name:BAHLS, LIA MARIE (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:LIA
Middle Name:MARIE
Last Name:BAHLS
Suffix:
Gender:
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1454 30TH ST STE 107
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-1311
Mailing Address - Country:US
Mailing Address - Phone:319-800-5564
Mailing Address - Fax:515-207-1485
Practice Address - Street 1:1454 30TH ST STE 107
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-1311
Practice Address - Country:US
Practice Address - Phone:319-800-5564
Practice Address - Fax:319-205-0058
Is Sole Proprietor?:No
Enumeration Date:2024-07-12
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAG180188363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health