Provider Demographics
NPI:1497524276
Name:BATEMAN, ANDREA VAN DYKE (RN)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:VAN DYKE
Last Name:BATEMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ANDEE
Other - Middle Name:V
Other - Last Name:BATEMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:21238 CARLTON CT
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46062-8001
Mailing Address - Country:US
Mailing Address - Phone:317-501-8426
Mailing Address - Fax:
Practice Address - Street 1:1700 E 38TH ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IN
Practice Address - Zip Code:46953-4568
Practice Address - Country:US
Practice Address - Phone:765-674-3321
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-21
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28200336A163WP0808X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health