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:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE253Z00000X, 3747P1801X
253Z00000X, 372500000X, 372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No253Z00000XAgenciesIn Home Supportive Care
No372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion