Provider Demographics
NPI:1144424250
Name:BAHR, LOIS B (RN BC)
Entity Type:Individual
Prefix:
First Name:LOIS
Middle Name:B
Last Name:BAHR
Suffix:
Gender:F
Credentials:RN BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 TALBOT STREET
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:MD
Mailing Address - Zip Code:21601
Mailing Address - Country:US
Mailing Address - Phone:410-822-1018
Mailing Address - Fax:410-820-5884
Practice Address - Street 1:300 TALBOT STREET
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601
Practice Address - Country:US
Practice Address - Phone:410-822-1018
Practice Address - Fax:410-820-5884
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2016-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDRO42261163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD367255700Medicaid