Basic Information
| Provider Information | |||||||||
| NPI: | 1063844496 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BATES | ||||||||
| FirstName: | PETER | ||||||||
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| Credential: | APRN-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 103 E LANYON ST | ||||||||
| Address2: | |||||||||
| City: | FRONTENAC | ||||||||
| State: | KS | ||||||||
| PostalCode: | 667632428 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6208203708 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1 MT CARMEL WAY | ||||||||
| Address2: | |||||||||
| City: | PITTSBURG | ||||||||
| State: | KS | ||||||||
| PostalCode: | 667627587 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6202316100 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/08/2013 | ||||||||
| LastUpdateDate: | 02/20/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 53-76045-041 | KS | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 163W00000X | 13-108275-041 | KS | N | Nursing Service Providers | Registered Nurse |
No ID Information.