Provider Demographics
NPI:1275921108
Name:BATES, AMBER
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:BATES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52392 STATE ROUTE 541
Mailing Address - Street 2:
Mailing Address - City:COSHOCTON
Mailing Address - State:OH
Mailing Address - Zip Code:43812-9185
Mailing Address - Country:US
Mailing Address - Phone:740-575-5142
Mailing Address - Fax:
Practice Address - Street 1:52392 STATE ROUTE 541
Practice Address - Street 2:
Practice Address - City:COSHOCTON
Practice Address - State:OH
Practice Address - Zip Code:43812-9185
Practice Address - Country:US
Practice Address - Phone:740-575-5142
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-30
Last Update Date:2014-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant