Provider Demographics
NPI:1093420564
Name:BATES, ASHLEE PAIGE (NP)
Entity Type:Individual
Prefix:
First Name:ASHLEE
Middle Name:PAIGE
Last Name:BATES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:912 W COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:PULASKI
Mailing Address - State:TN
Mailing Address - Zip Code:38478-3630
Mailing Address - Country:US
Mailing Address - Phone:931-424-9797
Mailing Address - Fax:931-424-9788
Practice Address - Street 1:326 N LOCUST AVE
Practice Address - Street 2:
Practice Address - City:LAWRENCEBURG
Practice Address - State:TN
Practice Address - Zip Code:38464-3516
Practice Address - Country:US
Practice Address - Phone:931-762-9797
Practice Address - Fax:931-762-9798
Is Sole Proprietor?:No
Enumeration Date:2023-01-19
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNF12220417363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN222083OtherSTATE BOARD