Provider Demographics
NPI:1013802156
Name:BASSETT, GAYLE RAYE (NP)
Entity type:Individual
Prefix:
First Name:GAYLE
Middle Name:RAYE
Last Name:BASSETT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:GAYLE
Other - Middle Name:RAYE
Other - Last Name:GLENN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1113 BERKSHIRE CT
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88005-1697
Mailing Address - Country:US
Mailing Address - Phone:575-496-3116
Mailing Address - Fax:
Practice Address - Street 1:1113 BERKSHIRE CT
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88005-1697
Practice Address - Country:US
Practice Address - Phone:575-496-3116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-10
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM84397363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily