Provider Demographics
NPI:1912595737
Name:BATES-MEEHAN, ERIN SHAE (RN)
Entity type:Individual
Prefix:MISS
First Name:ERIN
Middle Name:SHAE
Last Name:BATES-MEEHAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6911 NEWPORT COVE WAY
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823-7670
Mailing Address - Country:US
Mailing Address - Phone:916-832-8361
Mailing Address - Fax:
Practice Address - Street 1:6911 NEWPORT COVE WAY
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-7670
Practice Address - Country:US
Practice Address - Phone:916-832-8361
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-07
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95206413163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse