Provider Demographics
NPI:1801587589
Name:BACHER, AMANDA LYNN (APNP)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:LYNN
Last Name:BACHER
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4170 COUNTY ROAD R
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:WI
Mailing Address - Zip Code:53027-8839
Mailing Address - Country:US
Mailing Address - Phone:262-442-6469
Mailing Address - Fax:
Practice Address - Street 1:1407 N 8TH ST STE 203
Practice Address - Street 2:
Practice Address - City:SHEBOYGAN
Practice Address - State:WI
Practice Address - Zip Code:53081-3400
Practice Address - Country:US
Practice Address - Phone:920-415-0505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-15
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI13963-33363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health