Provider Demographics
NPI:1649773722
Name:BATES, KELSEY KAY (FNP-C)
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:KAY
Last Name:BATES
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 MURCHISON ST
Mailing Address - Street 2:
Mailing Address - City:FARMERSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75442-1617
Mailing Address - Country:US
Mailing Address - Phone:972-832-4614
Mailing Address - Fax:
Practice Address - Street 1:117 MURCHISON ST
Practice Address - Street 2:
Practice Address - City:FARMERSVILLE
Practice Address - State:TX
Practice Address - Zip Code:75442-1617
Practice Address - Country:US
Practice Address - Phone:972-832-4614
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-14
Last Update Date:2018-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP136482363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily