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General NPI Number Information
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NPI Number | 1639461726
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Entity Type | Individual
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Provider Name | PATRICIA BASS EVANS ANP
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Gender | Female
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Dates
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Enumeration Date | 05/06/2011
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Last Update Date | 06/18/2019
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Provider Practice Location Address
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Address Line | 4747 US HIGHWAY 19
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City | NEW PORT RICHEY
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State | FL
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Zip | 34652-4945
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Country | US
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Telephone | 727-494-7625
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Fax | 727-494-7629
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Provider Business Mailing Address
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Address Line | PO BOX 1289
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City | TAMPA
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State | FL
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Zip | 33601-1289
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Country | US
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Telephone | 252-847-4299
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | ARNP9394833
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License Number State | FL
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