Provider Demographics
NPI:1093086878
Name:BATES, VICTORIA MEREDITH (MS, LDN, RD)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:MEREDITH
Last Name:BATES
Suffix:
Gender:F
Credentials:MS, LDN, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 N ABEL ST
Mailing Address - Street 2:
Mailing Address - City:WINNFIELD
Mailing Address - State:LA
Mailing Address - Zip Code:71483-3260
Mailing Address - Country:US
Mailing Address - Phone:318-628-3986
Mailing Address - Fax:318-628-3988
Practice Address - Street 1:203 N ABEL ST
Practice Address - Street 2:
Practice Address - City:WINNFIELD
Practice Address - State:LA
Practice Address - Zip Code:71483-3260
Practice Address - Country:US
Practice Address - Phone:318-628-3986
Practice Address - Fax:318-628-3988
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-25
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA31133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered