Individual
STEPHANIE MARIE BASHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGAC-NP
Contact information
Practice address
2001 CRYSTAL SPRING AVE SW STE 201, ROANOKE, VA 24014-2465
(540) 853-0100
Mailing address
213 S JEFFERSON ST STE 1006, ROANOKE, VA 24011-1713
(540) 224-5715
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
0024183788
VA
Other
Enumeration date
06/13/2022
Last updated
11/18/2022
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