Healthcare Provider Details

I. General information

NPI: 1679404008
Provider Name (Legal Business Name): CAUSETTA LORAY BASS MSN, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1607 NW FEDERAL HWY
STUART FL
34994-9600
US

IV. Provider business mailing address

1607 NW FEDERAL HWY
STUART FL
34994-9600
US

V. Phone/Fax

Practice location:
  • Phone: 863-801-2116
  • Fax:
Mailing address:
  • Phone: 863-801-2116
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN11047766
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: