Provider Demographics
NPI:1538618152
Name:ANDREWS, SANDRA LINN (PHD, RDN, CFS)
Entity type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:LINN
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:PHD, RDN, CFS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8699 VERGENNES ST SE
Mailing Address - Street 2:
Mailing Address - City:ADA
Mailing Address - State:MI
Mailing Address - Zip Code:49301-8910
Mailing Address - Country:US
Mailing Address - Phone:616-299-7473
Mailing Address - Fax:
Practice Address - Street 1:8699 VERGENNES ST SE
Practice Address - Street 2:
Practice Address - City:ADA
Practice Address - State:MI
Practice Address - Zip Code:49301-8910
Practice Address - Country:US
Practice Address - Phone:616-299-7473
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-23
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI705863133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered