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Contact Information

TANIS BAST
1935 PRAIRIE DELL RD STE 500
UNION, MO63084-4329
 Phone: 636-649-3080
 Fax: 636-649-3081
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for TANIS BAST · (Female)

NPI # 1295193274
Status Active
Credentials
Entity Individual
Enumeration date 02/04/2016
Last updated 06/25/2024 - More than a year ago
Sole proprietor 1 No
Identifiers
  • MO License # 2016023261
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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