Provider Demographics
NPI:1669875225
Name:BASBY, SHARONDA LASHA (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:SHARONDA
Middle Name:LASHA
Last Name:BASBY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 ANGELINA GRACE DR
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-3295
Mailing Address - Country:US
Mailing Address - Phone:478-231-9223
Mailing Address - Fax:
Practice Address - Street 1:2054 WATSON BLVD
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31093-3634
Practice Address - Country:US
Practice Address - Phone:478-231-9223
Practice Address - Fax:478-918-0771
Is Sole Proprietor?:No
Enumeration Date:2014-09-26
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA207536363LF0000X
GARN207536363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily