Eriel Bass

Individual provider Active NPI Registered Nurse · Greenfield, IN

NPI 1154033702 · NPPES record last updated Dec 14, 2022

Key facts

NPI
1154033702
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
28253237A (IN)
Practice address
1501 N Salem CT
Greenfield, IN 46140-5544
Phone
(217) 459-9476
NPI assigned
Dec 14, 2022
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
28253237AINMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 28253237A IN Yes

Addresses

Primary practice location

1501 N Salem CT
Greenfield, IN 46140-5544

Mailing address

1501 N Salem CT
Greenfield, IN 46140-5544

Other identifiers

IdentifierTypeStateIssuer
100914104399MedicaidIN

Other providers in Greenfield, IN

All providers in Greenfield, IN · Registered Nurse in Indiana

Sources for this page

Verify at the official NPI Registry.