Provider Demographics
NPI:1740560945
Name:BATES, SHARON SUZETTE (NP-C)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:SUZETTE
Last Name:BATES
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:286 BACON RUN RD
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15322-6312
Mailing Address - Country:US
Mailing Address - Phone:724-678-8309
Mailing Address - Fax:
Practice Address - Street 1:286 BACON RUN RD
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15322-6312
Practice Address - Country:US
Practice Address - Phone:724-678-8309
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-19
Last Update Date:2011-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP011493363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily