Healthcare Provider Details

I. General information

NPI: 1225940521
Provider Name (Legal Business Name): LINDA MARIE BASURTO RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2451 E BASELINE RD STE 300
GILBERT AZ
85234-2465
US

IV. Provider business mailing address

2451 E BASELINE RD STE 300
GILBERT AZ
85234-2465
US

V. Phone/Fax

Practice location:
  • Phone: 480-626-7828
  • Fax:
Mailing address:
  • Phone: 480-626-7828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License NumberRN182554
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: