Provider Demographics
NPI:1649597915
Name:BATES, SARA ELIZABETH (RN)
Entity type:Individual
Prefix:MISS
First Name:SARA
Middle Name:ELIZABETH
Last Name:BATES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:954 WOFFORD LN
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:TN
Mailing Address - Zip Code:37352-4630
Mailing Address - Country:US
Mailing Address - Phone:931-759-6865
Mailing Address - Fax:
Practice Address - Street 1:151 MAJORS BLVD
Practice Address - Street 2:ROOM 1
Practice Address - City:LYNCHBURG
Practice Address - State:TN
Practice Address - Zip Code:37352-0196
Practice Address - Country:US
Practice Address - Phone:931-759-4251
Practice Address - Fax:931-759-6380
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-27
Last Update Date:2010-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000155233163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse