MEDICARE: BRITTANY LYN BAHLE PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	1063195006

General Provider Information

NPI Number	:	1063195006
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRITTANY LYN BAHLE PA-C

Provider Business Mailing Address
First Line	:	1448 N WEST BAY SHORE DR
Second Line	:
City	:	SUTTONS BAY
State	:	MI
Zip	:	49682-9373
Country	:	US
Telephone Number	:	231-645-3285
Fax Number	:

Provider Business Practice Location Address
First Line	:	1448 N WEST BAY SHORE DR
Second Line	:
City	:	SUTTONS BAY
State	:	MI
Zip	:	49682-9373
Country	:	US
Telephone Number	:	231-645-3285
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/08/2023
Last Update Date	:	08/21/2025

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