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Individual
VICKI L BAHLS
Active
Individual
VICKI L BAHLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28058063A
IN
363L00000X
Nurse Practitioner
Primary
71000085
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200351030
—
IN
01
—
500020063
RAIL ROAD MEDICARE
IN
Enumeration date
09/12/2005
Last updated
03/05/2014
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