Healthcare Provider Details

I. General information

NPI: 1275134801
Provider Name (Legal Business Name): ABRAM JAMES BASINGER FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/02/2020
Last Update Date: 01/25/2024
Certification Date: 01/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1174 E HOME RD
SPRINGFIELD OH
45503-2726
US

IV. Provider business mailing address

3956 SPARKHILL DR
ENON OH
45323-1436
US

V. Phone/Fax

Practice location:
  • Phone: 937-398-0354
  • Fax: 937-398-0358
Mailing address:
  • Phone: 567-208-2239
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0027702
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: