Judith Ann Bastean, MA
Individual provider Active NPI Audiologist · Fulton, MO
NPI 1043394331 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1043394331
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Audiologist 231H00000X
- License
- 01159 (MO)
- Practice address
- 850 West Hospital Drive
Suite a
Fulton, MO 65251-5147 - Phone
- (573) 592-0337
- Fax
- (573) 592-0711
- NPI assigned
- Oct 24, 2006
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Arts
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 01159 | MO | Yes |
Addresses
Primary practice location
850 West Hospital Drive
Suite a
Fulton, MO 65251-5147
Mailing address
4499 County Road 351
Fulton, MO 65251-5147
Phone (573) 642-0337
Other providers in Fulton, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.