Provider Demographics
NPI:1083167019
Name:BASS, JULIE M (APRN)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:M
Last Name:BASS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1941 SAVAGE RD
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-4704
Mailing Address - Country:US
Mailing Address - Phone:843-491-0509
Mailing Address - Fax:843-829-9502
Practice Address - Street 1:1941 SAVAGE RD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-4704
Practice Address - Country:US
Practice Address - Phone:843-491-0509
Practice Address - Fax:843-829-9502
Is Sole Proprietor?:No
Enumeration Date:2016-07-26
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH-426786163W00000X
COAPN.0998211-NP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse