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General NPI Number Information
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NPI Number | 1225811581
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Entity Type | Individual
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Provider Name | ELIZABETH ANN BATES BS HUMAN NUTRITION
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Gender | Female
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Dates
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Enumeration Date | 08/18/2023
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Last Update Date | 03/27/2025
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Provider Practice Location Address
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Address Line | 527 TUSKEGEE AIRMEN AVE
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City | SHEPPARD AIR FORCE BASE
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State | TX
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Zip | 76311
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Country | US
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Telephone | 904-504-9555
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Fax |
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Provider Business Mailing Address
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Address Line | 527 TUSKEGEE AIRMEN AIRMEN AVE.
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City | SHEPPARD AIR FORCE BASE
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State | TX
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Zip | 76311-3478
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Country | US
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Telephone | 904-504-5955
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 86113177
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 133VN1501X
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Taxonomy Name | Sports Dietetics Nutrition Registered Dietitian
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License Number | 86113177
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License Number State | TX
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