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General NPI Number Information
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NPI Number | 1124741046
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Entity Type | Individual
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Provider Name | AMY J BAHL CRNP
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Gender | Female
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Dates
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Enumeration Date | 09/26/2022
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Last Update Date | 10/31/2024
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Provider Practice Location Address
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Address Line | 965 SHAMROCK LN
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City | CORRY
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State | PA
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Zip | 16407-1196
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Country | US
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Telephone | 814-665-8288
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Fax | 814-664-8618
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Provider Business Mailing Address
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Address Line | 1 LECOM PL
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City | ERIE
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State | PA
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Zip | 16505-2571
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Country | US
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Telephone | 814-868-2529
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Fax | 814-868-2522
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | RN626746
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | SP026346
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License Number State | PA
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