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NPI Code Detail

MEDICARE: AMANDA ELAINE BAKEHORN CSFA

MEDICARE: AMANDA ELAINE BAKEHORN CSFA
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
1208600000XSurgery Physician100220641IIN

General Provider Information

NPI Number : 1942006812
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA ELAINE BAKEHORN CSFA
Provider Business Mailing Address
First Line : 1655 N CASS ST
Second Line :
City : WABASH
State : IN
Zip : 46992-9416
Country : US
Telephone Number : 260-425-6300
Fax Number : 260-569-2494
Provider Business Practice Location Address
First Line : 1655 N CASS ST
Second Line :
City : WABASH
State : IN
Zip : 46992-9416
Country : US
Telephone Number : 260-425-6300
Fax Number : 260-569-2494
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/21/2025
Last Update Date : 02/21/2025

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Directions to “ AMANDA ELAINE BAKEHORN CSFA” Practice Location

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