Individual
CODY LEE BACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
780 E WASHINGTON BLVD, CRESCENT CITY, CA 95531-8397
(775) 322-4550
(775) 322-4956
Mailing address
PO BOX 92227, LAS VEGAS, NV 89193-2227
(775) 322-4550
(775) 322-4956
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0994785
CO
363LF0000X
Family Nurse Practitioner
Primary
898368
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1598319642
—
UT
05
—
250043773
—
NV
Enumeration date
07/26/2019
Last updated
08/15/2026
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