NPI 1902843774 · live from the CMS NPI Registry
Genevieve T Bastos, PMHNP
Nurse Practitioner in Portage, MI. National Provider Identifier 1902843774, active.
NPI record
| NPI | 1902843774 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner 363L00000X |
| Practice location | 7895 Currier Dr Ste 100, Portage, MI 49002 |
| Practice phone | 269-910-7327 |
| Mailing address | 300 68th St Se, Grand Rapids, MI 49548 |
| Enumerated | June 1, 2006 |
| Last updated | September 14, 2026 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner, Psych/Mental Health | 363LP0808X | 4704216473 (MI) |
| Nurse Practitioner, Pediatrics | 363LP0200X | 4704216473 (MI) |
| Nurse Practitioner primary | 363L00000X | 4704216473 (MI) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.