Provider Demographics
NPI:1932321015
Name:BASS, CYNTHIA (STNA)
Entity Type:Individual
Prefix:MISS
First Name:CYNTHIA
Middle Name:
Last Name:BASS
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 BASSWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45405-3110
Mailing Address - Country:US
Mailing Address - Phone:937-275-4096
Mailing Address - Fax:
Practice Address - Street 1:118 BASSWOOD AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45405-3110
Practice Address - Country:US
Practice Address - Phone:937-275-4096
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide