Individual
SHANNON BATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
E-16137
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
E-16137
MISSISSIPPI BOARD OF PHARMACY
MS
Enumeration date
09/28/2022
Last updated
09/28/2022
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