Most Relevant Information
Provider Data
| NPI Number: | 1003461369 |
| Provider Name: | PHILLIP BASSETT |
| Entity Type: | Individual |
| Taxonomy Code: | 163W00000X |
| Specialty: | Registered Nurse |
| License Number: | 28223705A |
Most Important Dates
| Enumeration Date: | 08/05/2019 |
| Last Updated: | 10/12/2022 |
Provider Practice Location
11141 PARKVIEW PLAZA DR STE 310
FORT WAYNE
IN
468451714
Practice Location Phone/Fax
| Phone: | 2602668840 |
| Fax: | 2602668849 |
Provider Mailing Location
11109 PARKVIEW PLAZA DR # 117
FORT WAYNE
IN
468451701
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |