Provider Demographics
NPI:1013210525
Name:SOWDERS, LINDSEY A (RD, LD/N, CLC)
Entity Type:Individual
Prefix:MRS
First Name:LINDSEY
Middle Name:A
Last Name:SOWDERS
Suffix:
Gender:F
Credentials:RD, LD/N, CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3225 UNIVERSITY BLVD S
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-2762
Mailing Address - Country:US
Mailing Address - Phone:904-253-2003
Mailing Address - Fax:
Practice Address - Street 1:3225 UNIVERSITY BLVD S
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-2762
Practice Address - Country:US
Practice Address - Phone:904-253-2003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-06
Last Update Date:2010-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND5839133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered