Provider Demographics
NPI:1720351133
Name:BATES, TONYA SUE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:TONYA
Middle Name:SUE
Last Name:BATES
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57285 NEW CASTLE RD
Mailing Address - Street 2:
Mailing Address - City:JERUSALEM
Mailing Address - State:OH
Mailing Address - Zip Code:43747-9610
Mailing Address - Country:US
Mailing Address - Phone:740-827-1788
Mailing Address - Fax:
Practice Address - Street 1:57285 NEW CASTLE RD
Practice Address - Street 2:
Practice Address - City:JERUSALEM
Practice Address - State:OH
Practice Address - Zip Code:43747-9610
Practice Address - Country:US
Practice Address - Phone:740-827-1788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-15
Last Update Date:2012-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN101666164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse