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Individual

NICHOLAS BASS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
AGPCNP-BC

Contact information

Practice address
702 N MAIN ST, OPP, AL 36467-1626
(334) 493-3541
Mailing address
267 RIDGE DR, HEADLAND, AL 36345-7405
(334) 796-7670

Taxonomy

Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
1-144846
AL

Other

Enumeration date
11/07/2017
Last updated
03/17/2018
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