Provider Demographics
NPI:1124365689
Name:BATT, MARY ELIZABETH (BSN,RN, LMT)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:ELIZABETH
Last Name:BATT
Suffix:
Gender:F
Credentials:BSN,RN, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:652 BRUCE ST
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:KY
Mailing Address - Zip Code:40033-1068
Mailing Address - Country:US
Mailing Address - Phone:270-692-8433
Mailing Address - Fax:
Practice Address - Street 1:145 CEMETERY RD
Practice Address - Street 2:SUITE 2
Practice Address - City:LEBANON
Practice Address - State:KY
Practice Address - Zip Code:40033-1868
Practice Address - Country:US
Practice Address - Phone:270-699-2200
Practice Address - Fax:270-699-2244
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-03
Last Update Date:2013-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0007225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist