Healthcare Provider Details

I. General information

NPI: 1730672718
Provider Name (Legal Business Name): LORETTA ANN BASSION CRNP, FNP-BC, DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2018
Last Update Date: 06/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 OLD YORK RD
ABINGTON PA
19001-3720
US

IV. Provider business mailing address

2116 CHESTNUT ST APT UNIT2910
PHILADELPHIA PA
19103-4496
US

V. Phone/Fax

Practice location:
  • Phone: 215-481-2600
  • Fax: 215-481-4074
Mailing address:
  • Phone: 215-756-2030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP018912
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: