Provider Demographics
NPI:1487999660
Name:BATES, COURTNEY (CRNP)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:BATES
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:802 NEW HOLLAND AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-2287
Mailing Address - Country:US
Mailing Address - Phone:717-291-0700
Mailing Address - Fax:717-291-9634
Practice Address - Street 1:802 NEW HOLLAND AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-2287
Practice Address - Country:US
Practice Address - Phone:717-291-0700
Practice Address - Fax:717-291-9634
Is Sole Proprietor?:No
Enumeration Date:2012-11-29
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP012569363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily