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Individual

MADHURI BASAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RNC

Contact information

Practice address
4325 GRAND AVE, DULUTH, MN 55807-2730
(218) 722-1497
(218) 727-8646
Mailing address
4325 GRAND AVE, DULUTH, MN 55807-2730
(218) 722-1497
(218) 727-8646

Taxonomy

Speciality
Code
Description
License number
State
163WP2201X
Ambulatory Care Registered Nurse
Primary
12964
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
12964
LICENSE
MN
Enumeration date
08/30/2006
Last updated
07/08/2007
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