Melinda Bahler
Nurse Practitioner - Gerontology
900 Main St Ste 630
Peoria
, Illinois 61602-5024
Melinda Bahler
Nurse Practitioner - Gerontology
900 Main St Ste 630
Peoria
, Illinois 61602-5024
(309) 672-4433
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About
Features
Specialties
- Nurse Practitioner - Gerontology
Languages spoken
- English
Location
First Address
- Melinda Bahler
- 900 Main St Ste 630
- Peoria, IL
- Zip : 61602-5024
- Phone : (309) 672-4433
Second Address
- Melinda Bahler
- 900 Main St Ste 630
- Peoria, IL
- Zip : 61602-5024
- Phone : (309) 672-4433
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LG0600X | Nurse Practitioner - Gerontology | 209017573 | IL |
National Provider Identifier
| NPI | 1033608872 |
|---|---|
| Provider Name | Melinda Bahler |
| First Address | Peoria, IL 61602-5024 |
| Second Address | Peoria, IL 61602-5024 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 08/05/2018 |
| Last Update Date | 08/05/2018 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 209017573 | LICENSE (01) | IL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.