Provider Demographics
NPI:1497150072
Name:BATES, TERESA
Entity Type:Individual
Prefix:
First Name:TERESA
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 1:301 W ARMOUR BLVD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111-2072
Mailing Address - Country:US
Mailing Address - Phone:816-554-4293
Mailing Address - Fax:816-554-4360
Practice Address - Street 1:301 W ARMOUR BLVD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-2072
Practice Address - Country:US
Practice Address - Phone:816-554-4293
Practice Address - Fax:816-554-4360
Is Sole Proprietor?:No
Enumeration Date:2014-10-25
Last Update Date:2014-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2008034352163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse