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General NPI Number Information
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NPI Number | 1720343544
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Entity Type | Individual
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Provider Name | CATHERINE MARIE BASEL LPN
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Gender | Female
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Dates
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Enumeration Date | 07/09/2012
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Last Update Date | 07/09/2012
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Provider Practice Location Address
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Address Line | 944 SLATE DR
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City | BRUNSWICK
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State | OH
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Zip | 44212-6273
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Country | US
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Telephone | 330-460-0048
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Fax |
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Provider Business Mailing Address
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Address Line | 944 SLATE DRIVE BRUNSWICK
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City | BRUNSWICK
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State | OH
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Zip | 44212
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Country | US
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Telephone | 330-460-0048
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | PN.127891
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License Number State | OH
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