Provider Demographics
NPI:1770855017
Name:BASCH, TERRIANNE MARJORIE (CRNA)
Entity Type:Individual
Prefix:
First Name:TERRIANNE
Middle Name:MARJORIE
Last Name:BASCH
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:TERRIANNE
Other - Middle Name:MARJORIE
Other - Last Name:YODER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CRNA
Mailing Address - Street 1:2215 E WATERLOO RD
Mailing Address - Street 2:STE 313
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44312-3856
Mailing Address - Country:US
Mailing Address - Phone:330-208-2720
Mailing Address - Fax:330-208-2721
Practice Address - Street 1:1320 MERCY DR NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44708-2614
Practice Address - Country:US
Practice Address - Phone:330-489-1111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-02
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA-13033-NA367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered