Basen, Gretchen G

Basen, Gretchen G is an individual health care provider with primary practice located at 775 Pole Line Rd W Suite 115, Twin Falls ID 83301-5814. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Surgical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Basen, Gretchen G can be contacted via phone (208) 814-8150.

Contact Information

Primary practice address
775 Pole Line Rd W Suite 115 Twin Falls ID 83301-5814
Phone: (208) 814-8150
Fax: (208) 732-3112
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X C0001509 Maryland
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA-914 Idaho

Profile Details

NPI number 1861549396
LBN Legal business name Basen, Gretchen G
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 5th, 2007
Last updated Apr 14th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1861549396 NPPES
Idaho MEDICAID 1861549396

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