Healthcare Provider Details

I. General information

NPI: 1376457259
Provider Name (Legal Business Name): BATES PRIMARY CARE AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 VICTORY BLVD STE 200
MONROE LA
71203-2008
US

IV. Provider business mailing address

201 VICTORY BLVD STE 200
MONROE LA
71203-2008
US

V. Phone/Fax

Practice location:
  • Phone: 318-940-3732
  • Fax:
Mailing address:
  • Phone: 318-940-3732
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: MRS. LATASHA BATES
Title or Position: FOUNDER
Credential: FNP-C
Phone: 318-940-3732