Individual
MS. KATHLEEN BASHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
57392 M 51 S, DOWAGIAC, MI 49047-9766
(269) 390-1170
(269) 783-4015
Mailing address
57392 M 51 S, DOWAGIAC, MI 49047-9766
(269) 390-1170
(269) 783-4015
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601005601
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
74575
—
MI
Enumeration date
05/07/2010
Last updated
09/02/2025
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