Provider Demographics
NPI:1902850845
Name:BAHE, DEBORAH KAY (ARNP)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:KAY
Last Name:BAHE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MS
Other - First Name:DEBORAH
Other - Middle Name:KAY
Other - Last Name:MEISGEIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:115 S OLIVE ST
Mailing Address - Street 2:
Mailing Address - City:MAQUOKETA
Mailing Address - State:IA
Mailing Address - Zip Code:52060-3015
Mailing Address - Country:US
Mailing Address - Phone:319-652-4958
Mailing Address - Fax:319-652-2418
Practice Address - Street 1:115 S OLIVE ST
Practice Address - Street 2:
Practice Address - City:MAQUOKETA
Practice Address - State:IA
Practice Address - Zip Code:52060-3015
Practice Address - Country:US
Practice Address - Phone:319-652-4958
Practice Address - Fax:319-652-2418
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAC053758363L00000X
IAG053758363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1187559Medicaid
IA07636OtherWELLMARK BCBS
Q64795Medicare UPIN
IA1187559Medicaid