Individual
NICOLE ANDREA BASSETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
236 DON PASQUAL RD, LOS LUNAS, NM 87031
(505) 865-6223
(505) 866-2159
Mailing address
42 AVENIDA ALEGRE, LOS LUNAS, NM 87031-9538
(505) 917-8142
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
53892
NM
Other
Enumeration date
10/22/2019
Last updated
10/22/2019
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