Provider Demographics
NPI:1134768260
Name:SIMONS-SNEDDEN, ANDREA (MS, RDN, LDN)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:SIMONS-SNEDDEN
Suffix:
Gender:F
Credentials:MS, RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5304 CRISTINA DR
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16506-6004
Mailing Address - Country:US
Mailing Address - Phone:814-868-0046
Mailing Address - Fax:
Practice Address - Street 1:3727 CHERRY ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16508-2609
Practice Address - Country:US
Practice Address - Phone:814-460-4194
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-07
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA003342133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered