Provider Demographics
NPI:1235609819
Name:BATSON, ANTOINETTE (NP)
Entity Type:Individual
Prefix:
First Name:ANTOINETTE
Middle Name:
Last Name:BATSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ANTOINETTE
Other - Middle Name:
Other - Last Name:YOUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1350 CEDAR COURT
Mailing Address - Street 2:
Mailing Address - City:CARBONDALE
Mailing Address - State:IL
Mailing Address - Zip Code:62901
Mailing Address - Country:US
Mailing Address - Phone:618-529-2955
Mailing Address - Fax:618-457-7823
Practice Address - Street 1:1350 CEDAR COURT
Practice Address - Street 2:
Practice Address - City:CARBONDALE
Practice Address - State:IL
Practice Address - Zip Code:62901
Practice Address - Country:US
Practice Address - Phone:618-529-2955
Practice Address - Fax:618-457-7823
Is Sole Proprietor?:No
Enumeration Date:2018-11-27
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209018383207RN0300X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology