Healthcare Provider Details

I. General information

NPI: 1609609783
Provider Name (Legal Business Name): ERIN ALPHA BASINGER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ERIN ALPHA YATES

II. Dates (important events)

Enumeration Date: 08/23/2024
Last Update Date: 08/23/2024
Certification Date: 08/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 6TH AVE S
ST PETERSBURG FL
33701-4634
US

IV. Provider business mailing address

8262 31ST TER N
ST PETERSBURG FL
33710-2261
US

V. Phone/Fax

Practice location:
  • Phone: 727-898-7451
  • Fax:
Mailing address:
  • Phone: 727-215-2700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN11000588
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: