Basilicato, Susan

Basilicato, Susan is an individual health care provider with primary practice located at 1200 Mira Mar Ave , Medford OR 97504-8546. She recently has only one registered license in Nursing Service Providers / General Practice, which is considered as her primary health care specialty. Basilicato, Susan can be contacted via phone (541) 664-5151.

Contact Information

Primary practice address
1200 Mira Mar Ave Medford OR 97504-8546
Phone: (541) 664-5151
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / General Practice 163WG0000X 07804146RN Oregon

Profile Details

NPI number 1265403851
LBN Legal business name Basilicato, Susan
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 31st, 2006
Last updated Nov 26th, 2007 - about 19 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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