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Individual
SHANNON ELIZABETH BARES
Active
Individual
SHANNON ELIZABETH BARES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, CSR, LD
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
461
WY
133V00000X
Registered Dietitian
D-1419
ID
133V00000X
Registered Dietitian
LD-1261
NM
133VN1005X
Renal Nutrition Registered Dietitian
Primary
954764
—
Other
Enumeration date
02/06/2023
Last updated
02/06/2023
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