Individual
MICHAELA NICOLE BASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3742 WINTERFIELD RD, MIDLOTHIAN, VA 23113-9230
(804) 330-3335
Mailing address
536 PENINSULA DR, GILBERT, SC 29054-9251
(240) 994-8274
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110009139
VA
Other
Enumeration date
02/13/2023
Last updated
02/13/2023
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