Provider Demographics
NPI:1609329549
Name:BATES, KRISTI (RN, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:KRISTI
Middle Name:
Last Name:BATES
Suffix:
Gender:F
Credentials:RN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19904 AUGUSTA DR STE 3
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47025-7549
Mailing Address - Country:US
Mailing Address - Phone:812-577-3587
Mailing Address - Fax:812-203-8079
Practice Address - Street 1:19904 AUGUSTA DR STE 3
Practice Address - Street 2:
Practice Address - City:LAWRENCEBURG
Practice Address - State:IN
Practice Address - Zip Code:47025-7549
Practice Address - Country:US
Practice Address - Phone:812-577-3587
Practice Address - Fax:812-203-8079
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-27
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN393269163W00000X
OHAPRN.CNP.0027854363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse