Provider Demographics
NPI:1750137055
Name:BATSA, DAVID
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:BATSA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2010 RICH SMITH LN APT 609
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72032-4062
Mailing Address - Country:US
Mailing Address - Phone:978-221-0935
Mailing Address - Fax:
Practice Address - Street 1:1521 E FRANKLIN ST APT C204
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-2808
Practice Address - Country:US
Practice Address - Phone:978-221-0935
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-26
Last Update Date:2024-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR230835363LP0808X
NC336784163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse