Provider Demographics
NPI:1265655401
Name:BATSON, DESIREE R (ANP-BC)
Entity Type:Individual
Prefix:
First Name:DESIREE
Middle Name:R
Last Name:BATSON
Suffix:
Gender:F
Credentials:ANP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6401 MOUNTAIN VIEW RD
Mailing Address - Street 2:STE 101
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-6683
Mailing Address - Country:US
Mailing Address - Phone:423-495-5890
Mailing Address - Fax:866-663-1693
Practice Address - Street 1:6401 MOUNTAIN VIEW RD
Practice Address - Street 2:STE 101
Practice Address - City:OOLTEWAH
Practice Address - State:TN
Practice Address - Zip Code:37363-6683
Practice Address - Country:US
Practice Address - Phone:423-495-5890
Practice Address - Fax:866-663-1693
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2011-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000007665363LA2200X
TN7665363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN103I506791Medicare PIN