Provider Demographics
NPI:1043988280
Name:PITTS-BASKIN, URSULA (RN, BSN)
Entity Type:Individual
Prefix:
First Name:URSULA
Middle Name:
Last Name:PITTS-BASKIN
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6679 BEAGLE LN
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38002-5889
Mailing Address - Country:US
Mailing Address - Phone:901-279-8573
Mailing Address - Fax:
Practice Address - Street 1:6679 BEAGLE LN
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38002-5889
Practice Address - Country:US
Practice Address - Phone:901-279-8573
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-02
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000193374163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical