Provider Demographics
NPI:1497804116
Name:BATTS, KELLY S (CRNA)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:S
Last Name:BATTS
Suffix:
Gender:F
Credentials:CRNA
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Mailing Address - Street 1:150 KADER MERRITT RD
Mailing Address - Street 2:
Mailing Address - City:ROSE HILL
Mailing Address - State:NC
Mailing Address - Zip Code:28458-8672
Mailing Address - Country:US
Mailing Address - Phone:910-532-6532
Mailing Address - Fax:
Practice Address - Street 1:615 RIDGE RD
Practice Address - Street 2:SUITE 202
Practice Address - City:ROXBORO
Practice Address - State:NC
Practice Address - Zip Code:27573-4629
Practice Address - Country:US
Practice Address - Phone:336-503-5640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2008-09-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC141561367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2603324CMedicare PIN