Individual
MRS. KATHY DENESE BASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
PO BOX 170, INTERLACHEN, FL 32148-0170
(386) 684-0195
Mailing address
PO BOX 170, INTERLACHEN, FL 32148-0170
(386) 684-0195
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
NP-APRN11000137
FL
363LG0600X
Gerontology Nurse Practitioner
NP-APRN11000137
FL
Other
Enumeration date
06/07/2019
Last updated
12/23/2024
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