Provider Demographics
NPI:1134685399
Name:BAITS, BETHANY LYNNE (RD, LDN)
Entity Type:Individual
Prefix:MS
First Name:BETHANY
Middle Name:LYNNE
Last Name:BAITS
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 S JACKSON AVE FL 3
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15202-3428
Mailing Address - Country:US
Mailing Address - Phone:412-359-8951
Mailing Address - Fax:412-734-7795
Practice Address - Street 1:100 S JACKSON AVE FL 3
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15202-3428
Practice Address - Country:US
Practice Address - Phone:412-359-8951
Practice Address - Fax:412-734-7795
Is Sole Proprietor?:No
Enumeration Date:2019-02-13
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN006663133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
14418350OtherCAQH
PA103606489Medicaid