Individual provider · Type 1 NPI

Heather Larena Bascom, FNP

Family Nurse Practitioner · Medford, OR

NPI number 1124660154 Active

Practice location

2825 E Barnett Rd
Medford, OR 97504-8332

Specialties and licenses

Taxonomy	Code	License
Registered Nurse	163W00000X	362422-3102 (UT)
Family Nurse Practitioner	363LF0000X	362422-4405 (UT)
Family Nurse Practitioner Primary	363LF0000X	10021529 (OR)

Family Nurse Practitioner: Definition to come...

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About NPI 1124660154

Heather Larena Bascom, FNP's National Provider Identifier is 1124660154, issued on Oct 10, 2019. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Medford, OR. The record was last updated on Jul 18, 2024.