Healthcare Provider Details

I. General information

NPI: 1811394562
Provider Name (Legal Business Name): ANDREA BAIR R.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/24/2014
Last Update Date: 03/08/2025
Certification Date: 03/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3085 E FLAMINGO RD
LAS VEGAS NV
89121-4308
US

IV. Provider business mailing address

380 WATTS AVE
HAMPTON VA
23665-1822
US

V. Phone/Fax

Practice location:
  • Phone: 702-436-0835
  • Fax:
Mailing address:
  • Phone: 715-577-2030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: