Provider Demographics
NPI:1639359409
Name:BAZSO, CATHERINE (LPN)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:BAZSO
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:553 E PLAZA CIR
Mailing Address - Street 2:STE. A
Mailing Address - City:LITCHFIELD PARK
Mailing Address - State:AZ
Mailing Address - Zip Code:85340-4930
Mailing Address - Country:US
Mailing Address - Phone:623-535-6066
Mailing Address - Fax:
Practice Address - Street 1:5340 N. WIGWAM CREEK BLVD.
Practice Address - Street 2:
Practice Address - City:LITCHFIELD PARK
Practice Address - State:AZ
Practice Address - Zip Code:85340
Practice Address - Country:US
Practice Address - Phone:623-547-1418
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-09
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLP024828164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse