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General NPI Number Information
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NPI Number | 1912140237
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Entity Type | Individual
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Provider Name | AMY LYNN ANDERSON M.S., R.D., L.D./N
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Gender | Female
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Dates
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Enumeration Date | 04/16/2009
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Last Update Date | 09/28/2026
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Provider Practice Location Address
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Address Line | 2506 OLD FROSTBURG RD
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City | FROSTBURG
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State | MD
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Zip | 21532-4239
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Country | US
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Telephone | 832-552-3966
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Fax |
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Provider Business Mailing Address
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Address Line | 24042 HIGHWAY 59 N
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City | KINGWOOD
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State | TX
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Zip | 77339-1500
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Country | US
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Telephone | 832-552-3966
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number | D02036
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | DT81743
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License Number State | TX
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