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Individual

HALLEL PARALUMAN MAULLON BASCO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
FNP-C, RN

Contact information

Practice address
4730 N SOUTHSIDE PLAZA ST, RICHMOND, VA 23224-1742
(804) 230-7777
(804) 230-2071
Mailing address
PO BOX 91734, RICHMOND, VA 23291-1734
(804) 358-6100
(804) 342-7619

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001260044
VA
363LF0000X
Family Nurse Practitioner
Primary
0024176375
VA

Other

Enumeration date
07/16/2018
Last updated
12/13/2018
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