Individual provider · NPI-1
Magali Letizia Bacci, NP
Nurse Practitioner, Family · Bloomington, IN
NPI number1962285122
StatusActive
Last updated in NPPESMar 11, 2024
Details
- NPI
- 1962285122
- Entity type
- Individual (NPI-1)
- Name
- Magali Letizia Bacci
- Credential
- NP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 14, 2023
- Certification date
- Mar 11, 2024
- Last updated
- Mar 11, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | F02230273 | IN | Yes |
| 363LF0000X | Nurse Practitioner, Family | 71014941A | IN |
Practice location
2112 S Azalea LnBloomington, IN 47401-4595
Phone 812-837-2645
Mailing address
2112 S Azalea LnBloomington, IN 47401-4595
Phone 812-837-2645
Other practice locations
550 S Landmark Ave
Bloomington, IN 47403-3239
Bloomington, IN 47403-3239
Phone 812-333-5973 · Fax 812-330-3681
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