Provider Demographics
NPI:1467742874
Name:BASILE, CLARESE M (DNP, PMHNP-BC, NCC)
Entity Type:Individual
Prefix:MS
First Name:CLARESE
Middle Name:M
Last Name:BASILE
Suffix:
Gender:F
Credentials:DNP, PMHNP-BC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 W SAINT MARYS RD STE 160
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85745-2621
Mailing Address - Country:US
Mailing Address - Phone:520-309-3312
Mailing Address - Fax:
Practice Address - Street 1:1701 W SAINT MARYS RD STE 160
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85745
Practice Address - Country:US
Practice Address - Phone:520-309-3312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-19
Last Update Date:2018-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP11004363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health