Basic Information
Provider Information
NPI: 1932626082
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BACHMAN
FirstName: BETH
MiddleName: A
NamePrefix:  
NameSuffix:  
Credential: CRNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3421 CONCORD RD
Address2:  
City: YORK
State: PA
PostalCode: 174029001
CountryCode: US
TelephoneNumber: 7178511405
FaxNumber:  
Practice Location
Address1: 844 TUCK ST
Address2:  
City: LEBANON
State: PA
PostalCode: 170427477
CountryCode: US
TelephoneNumber: 7172748875
FaxNumber: 7176393955
Other Information
ProviderEnumerationDate: 08/29/2017
LastUpdateDate: 08/20/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/20/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163WE0003XRN597196PAN Nursing Service ProvidersRegistered NurseEmergency
363L00000XSP018527PAY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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