Individual
JILL BASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNS
Contact information
Practice address
2118 ROSALIND AVE SW, ROANOKE, VA 24014-1718
(540) 981-7653
(540) 981-7469
Mailing address
2419 GRAVEL HILL RD, VINTON, VA 24179-5580
Taxonomy
Speciality
Code
Description
License number
State
364SG0600X
Gerontology Clinical Nurse Specialist
Primary
0015-000581
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8900230
—
VA
Enumeration date
12/06/2005
Last updated
05/06/2008
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