Provider Demographics
NPI:1891200580
Name:BHASHIAM, RESMI (FNP-BC)
Entity Type:Individual
Prefix:
First Name:RESMI
Middle Name:
Last Name:BHASHIAM
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5820 N CANTON CENTER RD STE 120
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-2679
Mailing Address - Country:US
Mailing Address - Phone:734-981-2800
Mailing Address - Fax:
Practice Address - Street 1:5820 N CANTON CENTER RD STE 120
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-2679
Practice Address - Country:US
Practice Address - Phone:734-981-2800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-04
Last Update Date:2018-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704257962363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily