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Individual

SALLY REBECCA BASKETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
702 SW HIGGINS AVE, MISSOULA, MT 59803-1429
(406) 721-9543
Mailing address
154 REVAIS CREEK RD, DIXON, MT 59831-9519
(406) 246-0035

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
18203
MT

Other

Enumeration date
09/09/2010
Last updated
09/09/2010
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