Provider Demographics
NPI:1598557555
Name:BAHR, JODY RAE
Entity type:Individual
Prefix:
First Name:JODY
Middle Name:RAE
Last Name:BAHR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 N ELM ST
Mailing Address - Street 2:
Mailing Address - City:STELLA
Mailing Address - State:NE
Mailing Address - Zip Code:68442-6005
Mailing Address - Country:US
Mailing Address - Phone:402-883-7142
Mailing Address - Fax:
Practice Address - Street 1:606 N ELM ST
Practice Address - Street 2:
Practice Address - City:STELLA
Practice Address - State:NE
Practice Address - Zip Code:68442-6005
Practice Address - Country:US
Practice Address - Phone:402-883-7142
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-17
Last Update Date:2025-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE253Z00000X
253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care