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NPI Code Detail

MEDICARE: GREGORY BATES APRN, FNP

MEDICARE:   GREGORY  BATES  APRN, FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerCNP151066ME

General Provider Information

NPI Number : 1487022398
Entity Type Code : Individual
Provider Name (Legal Business Name) : GREGORY BATES APRN, FNP
Provider Business Mailing Address
First Line : 144 WOODFIELD RD
Second Line :
City : PORTLAND
State : ME
Zip : 04102-1864
Country : US
Telephone Number : 206-992-4281
Fax Number :
Provider Business Practice Location Address
First Line : 193 MAIN ST
Second Line :
City : NORWAY
State : ME
Zip : 04268-5645
Country : US
Telephone Number : 207-743-9292
Fax Number : 207-743-1578
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/09/2015
Last Update Date : 09/09/2015

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Directions to “ GREGORY BATES APRN, FNP” Practice Location

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