IndividualActive
Susan Basilicato, NP
NPI 1265403851 · General Practice Registered Nurse · Medford, OR
Provider details
- NPI number
- 1265403851
- Entity type
- Individual
- Primary specialty
- General Practice Registered NurseNursing Service Providers
- Credential
- NP
- Sex
- Female
- Sole proprietor
- No
- License
- 07804146RN (OR)
Specialties & taxonomies
Nursing Service Providers
Practice location
1200 Mira Mar Ave
Medford, OR 97504-8546
Phone: (541) 664-5151
Approximate (ZIP-level) locationGet directions
Mailing address
1208 Beall Ln
Central Point, OR 97502-1573
Registry dates
- Enumerated
- 2006-01-31
- Last updated
- 2007-11-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.