Individual
CRYSTAL AMMONS BATES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
105 HANES SQUARE CIR, WINSTON SALEM, NC 27103-5514
(336) 441-5569
Mailing address
105 HANES SQUARE CIR, WINSTON SALEM, NC 27103-5514
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
5011298
NC
363LF0000X
Family Nurse Practitioner
Primary
5011298
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
363LF0000X
—
NC
Enumeration date
02/12/2009
Last updated
06/05/2024
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