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Organization
DIABETES & KIDNEY DISEASE PREVENTION PROGRAM, LLC
Active
Organization
DIABETES & KIDNEY DISEASE PREVENTION PROGRAM, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE DANISE BATES FNP-BC (EXECUTIVE DIRECTOR, LIFESTYLE COACH)
(870) 718-6329
Entity
Organization
Contact information
Practice address
1007 FAIRWAY DR, PINE BLUFF, AR 71603-8105
(870) 718-6329
Mailing address
1007 FAIRWAY DR, PINE BLUFF, AR 71603-8105
(870) 718-6329
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
Primary
—
NULL
Other
Enumeration date
10/02/2026
Last updated
10/02/2026
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