Provider Demographics
NPI:1033971783
Name:BAS UZER, GUNIZ
Entity type:Individual
Prefix:
First Name:GUNIZ
Middle Name:
Last Name:BAS UZER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:GUNIZ
Other - Middle Name:
Other - Last Name:BAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:190 E BANNOCK ST
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83712-6241
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:600 N ROBBINS RD
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83702-4539
Practice Address - Country:US
Practice Address - Phone:208-489-4990
Practice Address - Fax:208-489-4063
Is Sole Proprietor?:No
Enumeration Date:2024-01-29
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID60338363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner