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NPI Code Detail

MEDICARE: ANDREA KENDRICK, RD, LLC

MEDICARE: ANDREA KENDRICK, RD, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered DietitianLDN0000002331TN

General Provider Information

NPI Number : 1316428659
Entity Type Code : Organization
Provider Name (Legal Business Name) : ANDREA KENDRICK, RD, LLC
Provider Business Mailing Address
First Line : 1319 PERSHING HILL LN
Second Line :
City : KNOXVILLE
State : TN
Zip : 37919-0701
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 407 N FOREST PARK BLVD
Second Line :
City : KNOXVILLE
State : TN
Zip : 37919-5136
Country : US
Telephone Number : 865-344-0949
Fax Number :
Authorized Official
Title or Position : REGISTERED DIETITIAN /OWNER
Name : ANDREA KENDRICK
Credential : RD
Telephone Number : 865-474-0211
Provider Enumeration Date : 08/24/2018
Last Update Date : 09/11/2018

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