Individual
MS. ROBERTA A BASQUES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
6601 N 27TH AVE, PHOENIX, AZ 85017-1219
(602) 336-0061
(602) 336-0249
Mailing address
3029 W ELM ST, PHOENIX, AZ 85017-3438
(602) 336-0061
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP006078
AZ
Other
Enumeration date
04/24/2007
Last updated
07/08/2007
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