Provider Demographics
NPI: | 1376896423 |
---|---|
Name: | BATES, HEATHER MARIE (RN, CNP) |
Entity Type: | Individual |
Prefix: | MS |
First Name: | HEATHER |
Middle Name: | MARIE |
Last Name: | BATES |
Suffix: | |
Gender: | F |
Credentials: | RN, CNP |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 33 NICHOLS PKWY STE 300 |
Mailing Address - Street 2: | |
Mailing Address - City: | HOOD RIVER |
Mailing Address - State: | OR |
Mailing Address - Zip Code: | 97031-3136 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 541-716-5786 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 33 NICHOLS PKWY STE 300 |
Practice Address - Street 2: | |
Practice Address - City: | HOOD RIVER |
Practice Address - State: | OR |
Practice Address - Zip Code: | 97031-3136 |
Practice Address - Country: | US |
Practice Address - Phone: | 541-716-5786 |
Practice Address - Fax: | |
Is Sole Proprietor?: | No |
Enumeration Date: | 2012-10-25 |
Last Update Date: | 2022-05-05 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NM | RN-75725 | 163W00000X |
NM | 7085 | 225700000X |
NM | CNP02752 | 363LF0000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No | 163W00000X | Nursing Service Providers | Registered Nurse | |
No | 225700000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Massage Therapist |