Provider Demographics
NPI:1821857616
Name:BATES, ASHLEY
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:BATES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15316 26TH ST SE
Mailing Address - Street 2:
Mailing Address - City:AMENIA
Mailing Address - State:ND
Mailing Address - Zip Code:58004-9753
Mailing Address - Country:US
Mailing Address - Phone:701-219-1447
Mailing Address - Fax:
Practice Address - Street 1:15316 26TH ST SE
Practice Address - Street 2:
Practice Address - City:AMENIA
Practice Address - State:ND
Practice Address - Zip Code:58004-9753
Practice Address - Country:US
Practice Address - Phone:701-219-1447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-15
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator