Healthcare Provider Details

I. General information

NPI: 1003899949
Provider Name (Legal Business Name): CATHERINE M BATEMAN PA
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/23/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4545 R ST SUITE 100
LINCOLN NE
68503-3723
US

IV. Provider business mailing address

4545 R ST SUITE 100
LINCOLN NE
68503-3723
US

V. Phone/Fax

Practice location:
  • Phone: 402-465-4545
  • Fax: 402-465-9011
Mailing address:
  • Phone: 402-465-4545
  • Fax: 402-465-9011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number1083
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: