Lisa Bates, R.N.

Individual provider Active NPI Registered Nurse · Pine Bluff, AR

NPI 1609204544 · NPPES record last updated Oct 30, 2013

Key facts

NPI
1609204544
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
R077639 (AR)
Practice address
3450 W 34TH Ave
Pine Bluff, AR 71603-5508
Phone
(870) 534-6067
Fax
(870) 534-7392
NPI assigned
Oct 30, 2013
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
R077639ARMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R077639 AR Yes

Addresses

Primary practice location

3450 W 34TH Ave
Pine Bluff, AR 71603-5508

Mailing address

1 Childrens Way
Slot 512-39
Little Rock, AR 72202-3500
Phone (501) 526-8700

Other providers in Pine Bluff, AR

All providers in Pine Bluff, AR · Registered Nurse in Arkansas

Sources for this page

Verify at the official NPI Registry.