Provider Demographics
NPI:1912775933
Name:BASNIGHT, HERMAN QUARZETTE II (FNP/C, MSN, BSN, RN)
Entity type:Individual
Prefix:
First Name:HERMAN
Middle Name:QUARZETTE
Last Name:BASNIGHT
Suffix:II
Gender:M
Credentials:FNP/C, MSN, BSN, RN
Other - Prefix:
Other - First Name:LAQUEITA
Other - Middle Name:QUARZETTE
Other - Last Name:MORNING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP/C, MSN, BSN, RN
Mailing Address - Street 1:1075 EVANS LN
Mailing Address - Street 2:
Mailing Address - City:ROBERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27871-9237
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1075 EVANS LN
Practice Address - Street 2:
Practice Address - City:ROBERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:27871-9237
Practice Address - Country:US
Practice Address - Phone:252-214-5150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-19
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251C00000X, 251E00000X, 320700000X, 320900000X, 322D00000X, 385HR2065X
NC320800000X, 320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251E00000XAgenciesHome Health
No320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
No385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child