Doctor Name: | MRS. SUSAN MARY BATES |
NPI Number: | 1417947318 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RN |
License Number: | N-26242 |
Business Practice Address: | 1115 B Street Plummer, ID - 83851 |
Business Phone Number: | 2086861931 |
Business Fax Number: | 2086861035 |
Mailing Address: | 268 Russel Ln, ST MARIES |
State: | ID |
Postal Code: | 838619332 |
Phone Number: | 2082452492 |
Fax Number: | |
NPI Enumeration Date: | 10/24/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WP2201X |
License Number: | N-26242 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ID |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Ambulatory Care |
Taxonomy Definition: |