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General NPI Number Information
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NPI Number | 1154599215
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Entity Type | Individual
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Provider Name | KEVIN W. BACHMANN L.P.N.
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Gender | Male
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Dates
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Enumeration Date | 02/12/2008
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Last Update Date | 02/12/2008
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Provider Practice Location Address
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Address Line | 43784 NYS ROUTE 37
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City | REDWOOD
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State | NY
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Zip | 13679
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Country | US
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Telephone | 315-482-6931
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 143 43784 ROUTE 37
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City | REDWOOD
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State | NY
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Zip | 13679-0143
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Country | US
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Telephone | 315-482-6931
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Fax |
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 253194-1
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License Number State | NY
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