Individual
ELIZABETH ANN BATES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BS HUMAN NUTRITION
Contact information
Practice address
527 TUSKEGEE AIRMEN AVE, SHEPPARD AIR FORCE BASE, TX 76311
(904) 504-9555
Mailing address
527 TUSKEGEE AIRMEN AIRMEN AVE., SHEPPARD AIR FORCE BASE, TX 76311-3478
(904) 504-5955
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
86113177
CO
133VN1501X
Sports Dietetics Nutrition Registered Dietitian
Primary
86113177
TX
Other
Enumeration date
08/18/2023
Last updated
03/27/2025
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