Provider Demographics
NPI:1063920452
Name:BATES, PAMELA ANN (APRN)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:ANN
Last Name:BATES
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:ANN
Other - Last Name:HINES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:163 WAGONWHEEL TER
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913-9030
Mailing Address - Country:US
Mailing Address - Phone:501-617-1045
Mailing Address - Fax:
Practice Address - Street 1:1 MERCY LN STE 505
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-6462
Practice Address - Country:US
Practice Address - Phone:501-623-2426
Practice Address - Fax:501-623-2405
Is Sole Proprietor?:No
Enumeration Date:2018-01-19
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA005333363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily