Keith Samuel Bass, NP-C Valid NPI

Individual provider · Family Nurse Practitioner · Anna, IL

NPI

1114440179

Type

Individual (Type 1)

Primary specialty

Family Nurse Practitioner (Nurse Practitioner)

Specialty group

Physician Assistants & Advanced Practice Nursing Providers

Taxonomy code

363LF0000X

License number

277002840 (IL)

Sex

Male

Sole proprietor

No

Enumerated

2017-07-21

Last updated

2024-01-05