Individual provider · NPI-1

Tina Rose Bass, RN

Registered Nurse, Psych/Mental Health, Adult · Fort Pierce, FL

NPI number1760750376
StatusActive
Last updated in NPPESDec 9, 2011

Details

NPI
1760750376
Entity type
Individual (NPI-1)
Name
Tina Rose Bass
Credential
RN
Sex
Female
Sole proprietor
No
Enumeration date
Dec 9, 2011
Last updated
Dec 9, 2011

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
163WP0809X Registered Nurse, Psych/Mental Health, Adult9301212FLYes

Practice location

4500 W Midway Rd
Fort Pierce, FL 34981-4823

Phone 772-672-8481

Mailing address

472 Sw Baoy Ave
Port St Lucie, FL 34953-3813

Phone 772-216-0770

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