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Individual

NANCY E BASS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
9000 W WISCONSIN AVE, MILWAUKEE, WI 53226-4874
(414) 266-3464
(414) 266-3466
Mailing address
9000 W WISCONSIN AVE, MILWAUKEE, WI 53226-4874
(414) 266-3464
(414) 266-3466

Taxonomy

Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
23087
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000182734
ANTHEM
OH
01
000000221329
UNISON
OH
01
000000525878
ANTHEM
OH
01
1015724700001
PA MEDICAID
PA
01
2098807
AETNA
OH
01
2114518
BCMH
OH
05
2114518
OH
01
363346
BUCKEYE
OH
01
740064
BUCKEYE
OH
01
P00412275
RAILROAD MEDICARE
OH
Enumeration date
07/21/2006
Last updated
09/12/2022
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