Bass, Kimberly Susan

Bass, Kimberly Susan is an individual health care provider with primary practice located at 1347 Larpenteur Ave W , Falcon Heights MN 55113-6302. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Bass, Kimberly Susan can be contacted via phone (651) 558-2020.

Contact Information

Primary practice address
1347 Larpenteur Ave W Falcon Heights MN 55113-6302
Phone: (651) 558-2020
Fax: (651) 487-2369
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 34550 Minnesota

Profile Details

NPI number 1801972674
LBN Legal business name Bass, Kimberly Susan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 27th, 2006
Last updated Feb 19th, 2009 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801972674 NPPES
Minnesota Other P00375969 RAILROAD MEDICARE

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