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NPI Code Detail

MEDICARE: TAMI VERNETTE BASS

MEDICARE:   TAMI VERNETTE BASS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225400000XRehabilitation Practitioner

General Provider Information

NPI Number : 1952682874
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAMI VERNETTE BASS
Provider Business Mailing Address
First Line : 3840 N COMMERCE ST
Second Line : STE. 200
City : NORTH LAS VEGAS
State : NV
Zip : 89032-8104
Country : US
Telephone Number : 702-646-7570
Fax Number :
Provider Business Practice Location Address
First Line : 2971 N GATEWAY RD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89115-7452
Country : US
Telephone Number : 702-591-3055
Fax Number : 702-432-6464
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/06/2011
Last Update Date : 04/17/2023

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Directions to “ TAMI VERNETTE BASS ” Practice Location

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