Provider Demographics
NPI:1497012850
Name:BAHR, PAMELA ANNE (RN)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:ANNE
Last Name:BAHR
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24695 US HIGHWAY 85
Mailing Address - Street 2:PMB 173
Mailing Address - City:FOUR CORNERS
Mailing Address - State:WY
Mailing Address - Zip Code:82715-9901
Mailing Address - Country:US
Mailing Address - Phone:307-746-9389
Mailing Address - Fax:
Practice Address - Street 1:420 DEANNE AVE
Practice Address - Street 2:
Practice Address - City:NEWCASTLE
Practice Address - State:WY
Practice Address - Zip Code:82701-2936
Practice Address - Country:US
Practice Address - Phone:307-746-4456
Practice Address - Fax:307-746-4470
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-23
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY163WP0808X163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health