Provider Demographics
NPI:1043184591
Name:RATES, NICOLE RENE (BS)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:RENE
Last Name:RATES
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:143 ASHLEY OAKS
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505-3678
Mailing Address - Country:US
Mailing Address - Phone:724-963-8580
Mailing Address - Fax:
Practice Address - Street 1:143 ASHLEY OAKS
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-3678
Practice Address - Country:US
Practice Address - Phone:724-963-8580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-29
Last Update Date:2025-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer