Provider Demographics
NPI:1467785287
Name:ANDREW, DIANA C (RD)
Entity Type:Individual
Prefix:MS
First Name:DIANA
Middle Name:C
Last Name:ANDREW
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1529 SABATINI DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-4132
Mailing Address - Country:US
Mailing Address - Phone:702-481-3672
Mailing Address - Fax:
Practice Address - Street 1:5235 S DURANGO DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-0197
Practice Address - Country:US
Practice Address - Phone:702-481-3672
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-11
Last Update Date:2009-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered