Individual
KESHIA BATES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPT
Contact information
Practice address
4024 ELKHART RD STE 26, GOSHEN, IN 46526-5803
(574) 366-2023
Mailing address
4024 ELKHART RD STE 26, GOSHEN, IN 46526-5803
(574) 366-2023
Taxonomy
Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
Primary
K4NR2N9
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9923882327
—
IN
Enumeration date
04/12/2024
Last updated
05/13/2024
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