Provider Demographics
NPI:1780008722
Name:BATES, STEFANIE ANNE (CNM)
Entity Type:Individual
Prefix:MRS
First Name:STEFANIE
Middle Name:ANNE
Last Name:BATES
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:336-277-0340
Mailing Address - Fax:336-277-0359
Practice Address - Street 1:1900 S HAWTHORNE RD STE 614
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-3901
Practice Address - Country:US
Practice Address - Phone:336-277-0340
Practice Address - Fax:336-277-0359
Is Sole Proprietor?:No
Enumeration Date:2014-02-11
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife