Brielle Bashore-Harris

Individual provider Active NPI Physician Assistant · Saint Joseph, MI

NPI 1548089741 · NPPES record last updated Apr 20, 2026

Key facts

NPI
1548089741
Entity type
Individual (NPI type 1)
Primary specialty
Physician Assistant 363A00000X
Practice address
3950 Hollywood Rd Ste 280
Saint Joseph, MI 49085-9151
Phone
(269) 982-3368
NPI assigned
Oct 7, 2024
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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MI Yes

Addresses

Primary practice location

3950 Hollywood Rd Ste 280
Saint Joseph, MI 49085-9151

Mailing address

PO Box 141
Baroda, MI 49101-0141

Other providers in Saint Joseph, MI

All providers in Saint Joseph, MI · Physician Assistant in Michigan

Sources for this page

Verify at the official NPI Registry.