Bass, Kenya Demeta

Bass, Kenya Demeta is an individual health care provider with primary practice located at 1905 Skibo Rd Ste 100 , Fayetteville NC 28314-0261. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Medical is her primary health care specialty. Bass, Kenya Demeta can be contacted via phone (910) 864-4357.

Contact Information

Primary practice address
1905 Skibo Rd Ste 100 Fayetteville NC 28314-0261
Phone: (910) 864-4357
Fax: (910) 221-0099
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 103419 North Carolina
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 103419 North Carolina

Profile Details

NPI number 1942387485
LBN Legal business name Bass, Kenya Demeta
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 1st, 2006
Last updated Jun 11th, 2019 - about 6 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 1942387485 NPPES
North Carolina MEDICAID 1942387485

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