Healthcare Provider Details

I. General information

NPI: 1629688494
Provider Name (Legal Business Name): ASHLEE LANE BATES MSN, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2020
Last Update Date: 01/09/2021
Certification Date: 01/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 BEARDSLEY LN STE 200
AUSTIN TX
78746-4945
US

IV. Provider business mailing address

300 BEARDSLEY LN STE 200
AUSTIN TX
78746-4945
US

V. Phone/Fax

Practice location:
  • Phone: 512-444-1414
  • Fax: 512-579-2720
Mailing address:
  • Phone: 512-444-1414
  • Fax: 512-579-2720

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1008004
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: