Individual
GLENDA BASTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
108 NEW GLENDALE RD, ELIZABETHTOWN, KY 42701-1023
(270) 769-1601
(270) 765-7274
Mailing address
PO BOX 2609, 108 NEW GLENDALE ROAD, ELIZABETHTOWN, KY 42702-2609
(270) 769-1601
(270) 765-7274
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1045777
KY
163WC1500X
Community Health Registered Nurse
Primary
1045777
KY
Other
Enumeration date
08/17/2016
Last updated
08/17/2016
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