Individual
KIMBERLY ELIZABETH BASTA
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MSNANP
Contact information
Practice address
3 UPTON PARK, ROCHESTER, NY 14607-1500
(585) 544-7012
Mailing address
162 SCHOLFIELD RD, ROCHESTER, NY 14617-4213
(585) 544-7012
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
303335-1
NY
Other
Enumeration date
05/23/2006
Last updated
07/08/2007
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