Provider Demographics
NPI:1104028075
Name:BACHMAN, JENNIFER EVE (PT)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:EVE
Last Name:BACHMAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8501 DOUGHTON DR
Mailing Address - Street 2:
Mailing Address - City:BAHAMA
Mailing Address - State:NC
Mailing Address - Zip Code:27503-8992
Mailing Address - Country:US
Mailing Address - Phone:919-620-6666
Mailing Address - Fax:
Practice Address - Street 1:8501 DOUGHTON DR
Practice Address - Street 2:
Practice Address - City:BAHAMA
Practice Address - State:NC
Practice Address - Zip Code:27503-8992
Practice Address - Country:US
Practice Address - Phone:919-620-6666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4863174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC4863OtherPHYSICAL THERAPY