Pamela L. Bahler, F.N.P.
Individual provider Active NPI Family Nurse Practitioner · Polacca, AZ
NPI 1265542336 · NPPES record last updated Oct 1, 2015
Key facts
- NPI
- 1265542336
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- RN111259 (AZ)
- Practice address
- Hwy 264 MMP 388
Polacca, AZ 86042 - Phone
- (928) 737-6000
- Fax
- (928) 737-6001
- NPI assigned
- Aug 30, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in AZ, TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040921000403 | AZ | Practitioner - Nurse Practitioner | 6901874601 | |
| I20091021000537 | TX | Practitioner - Nurse Practitioner | 6901874601 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN111259 | AZ | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DHHS IHS Phoenix Area | Nurse Practitioner | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | RN111259 | AZ | Yes |
Addresses
Primary practice location
Hwy 264 MMP 388
Polacca, AZ 86042
Mailing address
PO Box 4000
Polacca, AZ 86042
Phone (928) 737-6000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 893067 | Medicaid | AZ |
Other providers in Polacca, AZ
- Aziza H Abreha
- David Thurlow Ackley
- Hellen Adcock
- Akdhc, LLC
- Theresa K Barrick
- Elizabeth M Bayley
- Fredrick Bedoni
- Petra Bennefield
- Susan Elizabeth Bigley
All providers in Polacca, AZ · Family Nurse Practitioner in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 1, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.