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Individual

KATLYN BATES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
2525 GLENN HENDREN DR, LIBERTY, MO 64068-9625
(816) 407-5430
Mailing address
16187 HIGHWAY M, LAWSON, MO 64062-9283
(816) 588-7040

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2017022410
MO
363LF0000X
Family Nurse Practitioner
Primary
2022026229
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00000000
DO NOT HAVE ANY OTHER IDENTIFIERS
Enumeration date
01/17/2022
Last updated
07/28/2022
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