Individual provider · Type 1 NPI

Brandy M. Bates, PA-C

Medical Physician Assistant · Pocatello, ID

NPI number 1487886560 Active

Practice location

2434 S Fairway Dr
Pocatello, ID 83201-2372

Call (208) 851-9151 Map

Fax (208) 417-1822

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700X11217957-1206 (UT)
Physician Assistant 363A00000XPA-808 (ID)

Medical Physician Assistant: Definition to come...

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About NPI 1487886560

Brandy M. Bates, PA-C's National Provider Identifier is 1487886560, issued on Aug 21, 2009. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Pocatello, ID. The record was last updated on Dec 29, 2025.