Basham, Tiffany S.

Basham, Tiffany S. is an individual health care provider with primary practice located at 200 Brule Street , Fort Knox KY 40121. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Basham, Tiffany S. can be contacted via phone (502) 626-9681.

Contact Information

Primary practice address
200 Brule Street Fort Knox KY 40121
Phone: (502) 626-9681
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 3011255 Kentucky
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X APN0000019657 Tennessee
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 95015563 California

Profile Details

NPI number 1891188702
LBN Legal business name Basham, Tiffany S.
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 17th, 2015
Last updated Oct 6th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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