Individual
MRS. MARLENE G. BASKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
530 DEMOSS STREET, LORDSBURG, NM 88045-2618
(575) 542-8384
(575) 542-8367
Mailing address
530 DEMOSS STREET, LORDSBURG, NM 88045-2618
(575) 542-8384
(575) 542-8367
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
94-PA28
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
91430089
—
NM
Enumeration date
07/07/2005
Last updated
11/23/2009
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