Provider Demographics
NPI:1730931288
Name:FULP, ANDREA BELLAMY (RDN)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:BELLAMY
Last Name:FULP
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:339 BOBCAT TRL NW
Mailing Address - Street 2:
Mailing Address - City:FLOYD
Mailing Address - State:VA
Mailing Address - Zip Code:24091-3692
Mailing Address - Country:US
Mailing Address - Phone:804-347-6842
Mailing Address - Fax:
Practice Address - Street 1:339 BOBCAT TRL NW
Practice Address - Street 2:
Practice Address - City:FLOYD
Practice Address - State:VA
Practice Address - Zip Code:24091-3692
Practice Address - Country:US
Practice Address - Phone:804-347-6842
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-05
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered