Provider Demographics
NPI:1821641655
Name:BASSEY, SCHOLASTICA (CRNP)
Entity Type:Individual
Prefix:
First Name:SCHOLASTICA
Middle Name:
Last Name:BASSEY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3217 ABINGDON RD
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:MD
Mailing Address - Zip Code:21009-1015
Mailing Address - Country:US
Mailing Address - Phone:410-960-9936
Mailing Address - Fax:
Practice Address - Street 1:3217 ABINGDON RD
Practice Address - Street 2:
Practice Address - City:ABINGDON
Practice Address - State:MD
Practice Address - Zip Code:21009-1015
Practice Address - Country:US
Practice Address - Phone:410-960-9936
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-21
Last Update Date:2019-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR147093363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDR147093Medicaid