Provider Demographics
NPI:1558677088
Name:DAILEY BASSA, NATALIE R (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:NATALIE
Middle Name:R
Last Name:DAILEY BASSA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2912 DAUPHIN ISLAND PKWY
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36605-3839
Mailing Address - Country:US
Mailing Address - Phone:251-478-8200
Mailing Address - Fax:251-479-0790
Practice Address - Street 1:2912 DAUPHIN ISLAND PKWY
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36605-3839
Practice Address - Country:US
Practice Address - Phone:251-478-8200
Practice Address - Fax:251-479-0790
Is Sole Proprietor?:No
Enumeration Date:2010-08-21
Last Update Date:2010-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL14503183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist