Provider Demographics
NPI:1164092946
Name:KATHERINE ANDREW NUTRITION
Entity Type:Organization
Organization Name:KATHERINE ANDREW NUTRITION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/REGISTERED DIETICIAN
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDREW
Authorized Official - Suffix:
Authorized Official - Credentials:MPH, RD, LDN
Authorized Official - Phone:919-559-9475
Mailing Address - Street 1:2311 BYRD ST
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27608-1411
Mailing Address - Country:US
Mailing Address - Phone:919-559-9475
Mailing Address - Fax:919-504-5670
Practice Address - Street 1:2311 BYRD ST
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27608-1411
Practice Address - Country:US
Practice Address - Phone:919-559-9475
Practice Address - Fax:919-504-5670
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-25
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty