Provider Demographics
NPI:1528561370
Name:BASLER, LINDA SUZANNE (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:SUZANNE
Last Name:BASLER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1390 US HIGHWAY 61 STE 3300
Mailing Address - Street 2:
Mailing Address - City:FESTUS
Mailing Address - State:MO
Mailing Address - Zip Code:63028-4136
Mailing Address - Country:US
Mailing Address - Phone:636-933-5055
Mailing Address - Fax:636-933-3609
Practice Address - Street 1:1390 US HIGHWAY 61 STE 3300
Practice Address - Street 2:
Practice Address - City:FESTUS
Practice Address - State:MO
Practice Address - Zip Code:63028-4136
Practice Address - Country:US
Practice Address - Phone:636-933-5055
Practice Address - Fax:636-933-3609
Is Sole Proprietor?:No
Enumeration Date:2018-03-16
Last Update Date:2018-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOAG0218006033363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health