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Individual

MRS. JANICE BASS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
585 INTERSTATE DR., STE B, MANCHESTER, TN 37355
(931) 728-9000
(931) 728-2726
Mailing address
585 INTERSTATE DR., STE B, MANCHESTER, TN 37355
(931) 728-9000
(931) 728-2726

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN118603
TN
363LP2300X
Primary Care Nurse Practitioner
Primary
7750
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4323444
BLUE CROSS PROVIDER
TN
Enumeration date
06/02/2006
Last updated
04/28/2022
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