Individual
INA BASHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-2526
Mailing address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-2526
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RNA173044
ME
390200000X
Student in an Organized Health Care Education/Training Program
RN58278
ME
Other
Enumeration date
02/20/2016
Last updated
03/17/2018
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