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Individual
MR. MICHAEL JANSON BASS
Active
Individual
MR. MICHAEL JANSON BASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
RN181884
AZ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
291618
AZ
Other
Enumeration date
05/11/2023
Last updated
10/09/2024
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