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Individual

WALROSS JIM BASIT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
4544 BANCROFT AVE APT 4, LINCOLN, NE 68506-4272
(817) 454-3018
Mailing address
4544 BANCROFT AVE APT 4, LINCOLN, NE 68506-4272
(817) 454-3018

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
110041
NE

Other

Enumeration date
05/27/2016
Last updated
05/27/2016
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