Provider Demographics
NPI:1326596354
Name:OATES, DANIEL JOHN III (CRNP)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:JOHN
Last Name:OATES
Suffix:III
Gender:M
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49920A DYAS RD
Mailing Address - Street 2:
Mailing Address - City:BAY MINETTE
Mailing Address - State:AL
Mailing Address - Zip Code:36507-7300
Mailing Address - Country:US
Mailing Address - Phone:251-753-6287
Mailing Address - Fax:
Practice Address - Street 1:108 MCMEANS AVE
Practice Address - Street 2:
Practice Address - City:BAY MINETTE
Practice Address - State:AL
Practice Address - Zip Code:36507-3130
Practice Address - Country:US
Practice Address - Phone:251-937-7100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-19
Last Update Date:2019-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-105085363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily