Provider Demographics
NPI:1447014568
Name:BACHMAN, KYLA (FNP)
Entity type:Individual
Prefix:
First Name:KYLA
Middle Name:
Last Name:BACHMAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 SUGARBUSH CT
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44805-9737
Mailing Address - Country:US
Mailing Address - Phone:419-207-2750
Mailing Address - Fax:
Practice Address - Street 1:53 SUGARBUSH CT
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OH
Practice Address - Zip Code:44805-9737
Practice Address - Country:US
Practice Address - Phone:419-276-6370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-08
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCNP.0035732363LA2200X
OH0035732207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health