| NPI | 1740797398 |
|---|---|
| Former Name | MALLORY ELIZABETH BATES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2018004643) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2018004643) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-01-04 |
| Last Update Date | 2025-05-20 |