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Individual
DALLAS SCOTT BASHAM
Active
Individual
DALLAS SCOTT BASHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1097793
KY
163W00000X
Registered Nurse
RN.178465-1
OH
363L00000X
Nurse Practitioner
Primary
3003742
KY
363L00000X
Nurse Practitioner
COA.06624-NP
OH
363LA2100X
Acute Care Nurse Practitioner
3003742
KY
363LA2100X
Acute Care Nurse Practitioner
COA.06624-NP
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2328734
—
OH
Enumeration date
07/07/2006
Last updated
03/21/2016
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