Provider Demographics
NPI:1184753881
Name:BASFORD, BECKY LYNNE (CNP)
Entity type:Individual
Prefix:MS
First Name:BECKY
Middle Name:LYNNE
Last Name:BASFORD
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 N WILSON DR
Mailing Address - Street 2:ADAMS COUNTY HOSPITAL
Mailing Address - City:WEST UNION
Mailing Address - State:OH
Mailing Address - Zip Code:45693-1577
Mailing Address - Country:US
Mailing Address - Phone:937-544-1531
Mailing Address - Fax:937-544-1120
Practice Address - Street 1:210 N WILSON DR
Practice Address - Street 2:ADAMS COUNTY HOSPITAL
Practice Address - City:WEST UNION
Practice Address - State:OH
Practice Address - Zip Code:45693-1577
Practice Address - Country:US
Practice Address - Phone:937-544-1531
Practice Address - Fax:937-544-1120
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN212420363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2264615Medicaid
OH2264615Medicaid