Individual provider · NPI-1

Kathy Lynn Bashawaty, MSN, FNP-BC

Nurse Practitioner, Family · West Bloomfield, MI

NPI number1386935955

StatusActive

Last updated in NPPESFeb 19, 2021

Details

NPI: 1386935955
Entity type: Individual (NPI-1)
Name: Mrs. Kathy Lynn Bashawaty
Credential: MSN, FNP-BC
Sex: Female
Sole proprietor: Yes
Enumeration date: Apr 29, 2011
Certification date: Feb 19, 2021
Last updated: Feb 19, 2021

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
363LF0000X	Nurse Practitioner, Family	4704190275	MI	Yes

Practice location

6777 W Maple Rd
West Bloomfield, MI 48322-3013

Phone 248-325-1000

Mailing address

1407 Vinsetta Blvd
Royal Oak, MI 48067-1028

Phone 248-439-0209

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.