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Individual

ALICIA KAY BATES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
1100 MERCER AVE, DECATUR, IN 46733-2303
(260) 724-2145
(260) 724-2145
Mailing address
955 HIGH ST, STE 2, DECATUR, IN 46733-2326
(260) 724-8700
(260) 728-3821

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71001926A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000373877
ANTHEM
IN
05
200530800
IN
Enumeration date
01/18/2006
Last updated
07/21/2022
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