Provider Demographics
NPI:1013490739
Name:BASSETT, CISSY ELIZABETH (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:CISSY
Middle Name:ELIZABETH
Last Name:BASSETT
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 1:537 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:AVONMORE
Mailing Address - State:PA
Mailing Address - Zip Code:15618-1252
Mailing Address - Country:US
Mailing Address - Phone:724-882-4135
Mailing Address - Fax:
Practice Address - Street 1:2501 WARREN RD
Practice Address - Street 2:
Practice Address - City:INDIANA
Practice Address - State:PA
Practice Address - Zip Code:15701-3280
Practice Address - Country:US
Practice Address - Phone:724-349-5620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-09
Last Update Date:2018-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP018751363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily