Provider Demographics
NPI:1649091034
Name:BATES, HEIDI DENISE (RN)
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:DENISE
Last Name:BATES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:HEIDI
Other - Middle Name:D
Other - Last Name:STINEBAUGH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:29012 N SELKIRK VIEW DR
Mailing Address - Street 2:
Mailing Address - City:CHATTAROY
Mailing Address - State:WA
Mailing Address - Zip Code:99003-8831
Mailing Address - Country:US
Mailing Address - Phone:928-486-6808
Mailing Address - Fax:
Practice Address - Street 1:611 N IRON BRIDGE WAY
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-4932
Practice Address - Country:US
Practice Address - Phone:509-444-8888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-18
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60482374163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse