Provider Demographics
NPI:1700164639
Name:SCHAUB, ELIZABETH DAWN (RD/LD, CDE)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:DAWN
Last Name:SCHAUB
Suffix:
Gender:F
Credentials:RD/LD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 DOBSON BRANCH TRL
Mailing Address - Street 2:
Mailing Address - City:NOLENSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37135-9511
Mailing Address - Country:US
Mailing Address - Phone:972-689-2600
Mailing Address - Fax:
Practice Address - Street 1:327 DOBSON BRANCH TRL
Practice Address - Street 2:
Practice Address - City:NOLENSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37135-9511
Practice Address - Country:US
Practice Address - Phone:972-689-2600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-26
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT05467133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered