Individual
MRS. KATHY LYNN BASHAWATY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN, FNP-BC
Contact information
Practice address
6777 W MAPLE RD, WEST BLOOMFIELD, MI 48322-3013
(248) 325-1000
Mailing address
1407 VINSETTA BLVD, ROYAL OAK, MI 48067-1028
(248) 439-0209
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704190275
MI
Other
Enumeration date
04/29/2011
Last updated
02/19/2021
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