Healthcare Provider Details

I. General information

NPI: 1851524532
Provider Name (Legal Business Name): HEATHER KEEDY BATEMAN CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2009
Last Update Date: 07/12/2023
Certification Date: 02/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

535 SCHILLINGER RD S STE A
MOBILE AL
36695-8915
US

IV. Provider business mailing address

535 SCHILLINGER RD S STE A
MOBILE AL
36695-8915
US

V. Phone/Fax

Practice location:
  • Phone: 251-525-9933
  • Fax:
Mailing address:
  • Phone: 251-525-9933
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR870894
License Number StateMS
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN 9253705
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1-092062
License Number StateAL
# 4
Primary TaxonomyN
Taxonomy Code163WI0500X
TaxonomyInfusion Therapy Registered Nurse
License NumberR870894
License Number StateMS
# 5
Primary TaxonomyN
Taxonomy Code163WI0500X
TaxonomyInfusion Therapy Registered Nurse
License NumberRN 9253705
License Number StateFL
# 6
Primary TaxonomyN
Taxonomy Code163WI0500X
TaxonomyInfusion Therapy Registered Nurse
License Number1-092062
License Number StateAL
# 7
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCRNP1-092062
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: