Basic Information
Provider Information
NPI: 1033838396
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BASNET
FirstName: GAURIMA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6400 E BROAD ST STE 400
Address2:  
City: COLUMBUS
State: OH
PostalCode: 432132979
CountryCode: US
TelephoneNumber: 6146553345
FaxNumber: 6143174689
Practice Location
Address1: 6400 E BROAD ST STE 400
Address2:  
City: COLUMBUS
State: OH
PostalCode: 432132979
CountryCode: US
TelephoneNumber: 6146553345
FaxNumber: 6143174689
Other Information
ProviderEnumerationDate: 08/22/2022
LastUpdateDate: 08/22/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/22/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
164W00000XLPN.181468.MEDS-IVOHY Nursing Service ProvidersLicensed Practical Nurse 

No ID Information.


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