Healthcare Provider Details

I. General information

NPI: 1831136209
Provider Name (Legal Business Name): DANA KARLENE BATES ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 01/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 SAINT PAUL AVE
LINCOLN NE
68504-2760
US

IV. Provider business mailing address

5000 SAINT PAUL AVE
LINCOLN NE
68504-2760
US

V. Phone/Fax

Practice location:
  • Phone: 402-465-7545
  • Fax: 402-465-2170
Mailing address:
  • Phone: 402-465-7545
  • Fax: 402-465-2170

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number341
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: