Bashura, Holly R
Bashura, Holly R is an individual health care provider with primary practice located at 4699 Main St Suite 105, Bridgeport CT 06606-1830. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Bashura, Holly R can be contacted via phone (203) 374-6162.Contact Information
Primary practice address
4699 Main St Suite 105
Bridgeport CT 06606-1830
Phone: (203) 374-6162
Fax: (203) 374-1549
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 002970 | Connecticut |
Profile Details
| NPI number | 1194771758 |
|---|---|
| LBN Legal business name | Bashura, Holly R |
| Credentials | Advanced Practice Registered Nurse (APRN) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 25th, 2006 |
| Last updated | Sep 11th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1194771758 | NPPES |
| Connecticut | MEDICAID | 004258267 |
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