Healthcare Provider Details

I. General information

NPI: 1942534086
Provider Name (Legal Business Name): JUNE HODGES BASNIGHT RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2009
Last Update Date: 07/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 E 1ST AVENUE EXT SUITE 10
LEXINGTON NC
27292-3368
US

IV. Provider business mailing address

284 EXECUTIVE PARK DR SUITE 100
CONCORD NC
28025-1831
US

V. Phone/Fax

Practice location:
  • Phone: 336-242-2450
  • Fax: 336-249-9920
Mailing address:
  • Phone: 704-939-1100
  • Fax: 704-939-1173

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number56102
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: