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General NPI Number Information
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NPI Number | 1538730494
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Entity Type | Individual
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Provider Name | VERONICA EDITH BASS APRN
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Gender | Female
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Dates
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Enumeration Date | 07/01/2021
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Last Update Date | 07/01/2021
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Provider Practice Location Address
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Address Line | 2000 HARTMAN RD STE 1
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City | FORT PIERCE
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State | FL
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Zip | 34947-4413
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Country | US
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Telephone | 772-465-1170
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Fax |
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Provider Business Mailing Address
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Address Line | 2597 12TH SQ SW
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City | VERO BEACH
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State | FL
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Zip | 32968-5065
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Country | US
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Telephone | 772-501-6522
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11013594
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License Number State | FL
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