Provider Demographics
NPI:1538130679
Name:BATES, SHIRLEY HELEN (CRNA)
Entity Type:Individual
Prefix:MS
First Name:SHIRLEY
Middle Name:HELEN
Last Name:BATES
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:MS
Other - First Name:SHIRLEY
Other - Middle Name:HELEN
Other - Last Name:BATES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1450 WESTERN AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12203-3539
Mailing Address - Country:US
Mailing Address - Phone:518-463-0050
Mailing Address - Fax:518-207-2973
Practice Address - Street 1:1450 WESTERN AVE STE 102
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203-3539
Practice Address - Country:US
Practice Address - Phone:518-463-0050
Practice Address - Fax:518-207-2973
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY452579-1367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered