Individual
STEPHANIE BASHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNAP, CRNA
Contact information
Practice address
896 MILFORD RD, HOLLY, MI 48442-1664
(248) 212-6423
Mailing address
896 MILFORD RD, HOLLY, MI 48442-1664
(248) 212-6423
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704326355
MI
Other
Enumeration date
06/09/2021
Last updated
12/19/2024
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