1457098436 NPI number — CATHERINE JEAN PROBASCO-BASLER APN-C

Table of content: CATHERINE JEAN PROBASCO-BASLER APN-C (NPI 1457098436)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457098436 NPI number — CATHERINE JEAN PROBASCO-BASLER APN-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PROBASCO-BASLER
Provider First Name:
CATHERINE
Provider Middle Name:
JEAN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
APN-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BASLER
Provider Other First Name:
CATHI
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
NP
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1457098436
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/19/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
28 BROKEN WING DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW CASTLE
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
81647-8514
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-437-1727
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
HOME CARE AND HOSPICE OF THE VALLEY
Provider Second Line Business Practice Location Address:
823 GRAND AVE
Provider Business Practice Location Address City Name:
GLENWOOD SPRINGS
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
81601
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
970-930-6008
Provider Business Practice Location Address Fax Number:
970-927-6659
Provider Enumeration Date:
05/19/2022

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363L00000X , with the licence number:  APN.0002817-NP , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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