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General NPI Number Information
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NPI Number | 1629677976
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Entity Type | Individual
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Provider Name | ELIZABETH BASSITY NP
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Gender | Female
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Dates
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Enumeration Date | 10/19/2020
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Last Update Date | 05/13/2025
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Provider Practice Location Address
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Address Line | 529 5TH ST
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City | BROCKTON
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State | MT
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Zip | 59213
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Country | US
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Telephone | 406-786-3202
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Fax | 406-412-2993
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Provider Business Mailing Address
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Address Line | 24 JAMES ST
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City | WADDINGTON
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State | NY
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Zip | 13694-3103
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Country | US
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Telephone | 607-262-6240
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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 | NUR-APRN-LIC-233680
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License Number State | MT
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