HOLLY R BASHURA APRN NPI 1194771758

NPI Information

NPI: 1194771758
Provider Name: HOLLY R BASHURA, APRN
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
4699 MAIN ST
SUITE 105
BRIDGEPORT, CT
ZIP 06606
Phone: (203) 374-6162
Get Directions

Holly R Bashura, APRN is a family nurse practitioner in Bridgeport, CT with 21 years of experience. Holly R Bashura, APRN NPI is 1194771758. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4699 MAIN ST
SUITE 105
BRIDGEPORT, CT
ZIP 06606-830
Phone: (203) 374-6162
Fax: (203) 374-1549

The NPI 1194771758 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/25/2006 and was last updated on 9/11/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	002970	CONNECTICUT	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	004258267	MEDICAID	CONNECTICUT
2	500001672	MEDICARE ID-TYPE UNSPECIFIED	CONNECTICUT
3	Q66728	MEDICARE UPIN	CONNECTICUT

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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