Individual
JEAN BASNIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1224 E MAIN ST, HAVELOCK, NC 28532
(252) 447-7474
Mailing address
110 STAFFORDSHIRE DRIVE, NEW BERN, NC 28562-8441
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
200701959
NC
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
2007-01959
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
139638419
—
TX
01
—
8P5517
BCBS PROV. NO.
TX
Enumeration date
10/12/2005
Last updated
06/30/2018
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