Individual
HOLLY R BASHURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
4699 MAIN ST, SUITE 105, BRIDGEPORT, CT 06606-1830
(203) 374-6162
(203) 374-1549
Mailing address
4699 MAIN ST, SUITE 105, BRIDGEPORT, CT 06606-1830
(203) 374-6162
(203) 374-1549
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
002970
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004258267
—
CT
Enumeration date
05/25/2006
Last updated
09/11/2007
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