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Individual

MRS. TANYA R BASSETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DNP, MHPNP

Contact information

Practice address
46 ALBION ST, SOUTHWEST COMMUNITY HEALTH CENTER, BRIDGEPORT, CT 06605-2602
(203) 330-6000
(203) 330-6010
Mailing address
46 ALBION ST, SOUTHWEST COMMUNITY HEALTH, BRIDGEPORT, CT 06605-2602
(203) 330-6000
(203) 330-6010

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1801293824
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
005987
CONNECTICUT LICENSE
CT
Enumeration date
11/20/2014
Last updated
11/12/2015
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