Provider Demographics
NPI:1972260776
Name:BASH, JASMINE DANIELLE
Entity Type:Individual
Prefix:
First Name:JASMINE
Middle Name:DANIELLE
Last Name:BASH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 80
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43058-0080
Mailing Address - Country:US
Mailing Address - Phone:740-670-4818
Mailing Address - Fax:
Practice Address - Street 1:2417 HARTFORD AVE
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-1819
Practice Address - Country:US
Practice Address - Phone:740-670-4818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-29
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker