Healthcare Provider Details

I. General information

NPI: 1659972677
Provider Name (Legal Business Name): BEGUM BATES PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BEGUM GOCMEN PMHNP-BC

II. Dates (important events)

Enumeration Date: 11/05/2020
Last Update Date: 01/12/2026
Certification Date: 01/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4895 MONROE ST STE 203
TOLEDO OH
43623-4349
US

IV. Provider business mailing address

4895 MONROE ST STE 203
TOLEDO OH
43623-4349
US

V. Phone/Fax

Practice location:
  • Phone: 419-725-2527
  • Fax:
Mailing address:
  • Phone: 419-725-2527
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0027703
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: