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Individual

ALINE MARIE BASS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
1728 VIRGINIA BEACH BLVD STE 113, VIRGINIA BEACH, VA 23454-4533
(757) 437-0411
(757) 552-0378
Mailing address
1728 VIRGINIA BEACH BLVD, SUITE 113, VIRGINIA BEACH, VA 23454
(757) 437-0411
(757) 552-0378

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
0002095397
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0002095397
LPN
VA
Enumeration date
07/19/2021
Last updated
08/10/2021
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