Provider Demographics
NPI:1740052075
Name:BATES, COURTNEY MARIE (CRNP)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:MARIE
Last Name:BATES
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:27550 STATE HIGHWAY 75 STE 105
Mailing Address - Street 2:
Mailing Address - City:ONEONTA
Mailing Address - State:AL
Mailing Address - Zip Code:35121-3204
Mailing Address - Country:US
Mailing Address - Phone:205-625-5711
Mailing Address - Fax:205-625-3034
Practice Address - Street 1:27550 STATE HIGHWAY 75 STE 105
Practice Address - Street 2:
Practice Address - City:ONEONTA
Practice Address - State:AL
Practice Address - Zip Code:35121-3204
Practice Address - Country:US
Practice Address - Phone:205-625-5711
Practice Address - Fax:205-625-5711
Is Sole Proprietor?:No
Enumeration Date:2023-10-30
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-147446207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine