Jana Marie Bakle, RN

Individual provider Active NPI Registered Nurse · Fort Wayne, IN

NPI 1306478573 · NPPES record last updated Feb 6, 2020

Key facts

NPI
1306478573
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
28188725A (IN)
Practice address
2121 Lake Ave
Fort Wayne, IN 46805-5100
Phone
(260) 426-5431
NPI assigned
Feb 6, 2020
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
28188725AINMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 28188725A IN Yes

Addresses

Primary practice location

2121 Lake Ave
Fort Wayne, IN 46805-5100

Mailing address

2121 Lake Ave
Fort Wayne, IN 46805-5100
Phone (260) 426-5431

Other names

  • Jana Marie Mahathy Former name

Other providers in Fort Wayne, IN

All providers in Fort Wayne, IN · Registered Nurse in Indiana

Sources for this page

Verify at the official NPI Registry.