Provider Demographics
NPI:1013130376
Name:BASLER, BETH ANNE (NP)
Entity type:Individual
Prefix:MRS
First Name:BETH
Middle Name:ANNE
Last Name:BASLER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MRS
Other - First Name:BETH
Other - Middle Name:ANNE
Other - Last Name:BUTLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:5690 CAMPUS PKWY
Mailing Address - Street 2:
Mailing Address - City:HAZELWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63042-2335
Mailing Address - Country:US
Mailing Address - Phone:314-731-8888
Mailing Address - Fax:314-731-1621
Practice Address - Street 1:5690 CAMPUS PKWY
Practice Address - Street 2:
Practice Address - City:HAZELWOOD
Practice Address - State:MO
Practice Address - Zip Code:63042-2335
Practice Address - Country:US
Practice Address - Phone:314-731-8888
Practice Address - Fax:314-731-8888
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO132494363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily