Provider Demographics
NPI:1376972281
Name:CHANDLER, KRISTIE (RD, LDN)
Entity Type:Individual
Prefix:
First Name:KRISTIE
Middle Name:
Last Name:CHANDLER
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2730 FYNAMORE LN
Mailing Address - Street 2:
Mailing Address - City:DOWNINGTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19335-6027
Mailing Address - Country:US
Mailing Address - Phone:484-947-3314
Mailing Address - Fax:
Practice Address - Street 1:460 CREAMERY WAY
Practice Address - Street 2:SUITE 104
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-2533
Practice Address - Country:US
Practice Address - Phone:610-280-7960
Practice Address - Fax:610-280-7962
Is Sole Proprietor?:No
Enumeration Date:2013-11-01
Last Update Date:2013-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN004252133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered