Provider Demographics
NPI:1275680449
Name:FRANK, SANDRA KAY (MS, RD, LD, CDCES)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:KAY
Last Name:FRANK
Suffix:
Gender:F
Credentials:MS, RD, LD, CDCES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 N 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:SANDPOINT
Mailing Address - State:ID
Mailing Address - Zip Code:83864-1507
Mailing Address - Country:US
Mailing Address - Phone:208-265-1116
Mailing Address - Fax:208-265-6270
Practice Address - Street 1:520 N 3RD AVE
Practice Address - Street 2:
Practice Address - City:SANDPOINT
Practice Address - State:ID
Practice Address - Zip Code:83864-1507
Practice Address - Country:US
Practice Address - Phone:208-265-1116
Practice Address - Fax:208-265-6270
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2021-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDD-1243133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDD-1243OtherID STATE BOARD OF MEDICINE
OR608OtherOR BOARD OF LICENSED RD'S