Individual
JENNIFER D BASHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
200 12TH STREET EXT, PRINCETON, WV 24740-2329
(304) 425-9541
(304) 487-3984
Mailing address
702 THORNTON AVE, PRINCETON, WV 24740-2855
(304) 425-9541
(304) 487-3984
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
30708
WV
Other
Enumeration date
06/12/2026
Last updated
06/12/2026
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