Provider Demographics
NPI:1477822526
Name:ANDRY, JEANNE SCHMIDT (RD)
Entity Type:Individual
Prefix:MRS
First Name:JEANNE
Middle Name:SCHMIDT
Last Name:ANDRY
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 1:4482 GARLAND LN
Mailing Address - Street 2:
Mailing Address - City:PASS CHRISTIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39571-5709
Mailing Address - Country:US
Mailing Address - Phone:228-452-4377
Mailing Address - Fax:228-863-0802
Practice Address - Street 1:3300 15TH ST
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39501-3901
Practice Address - Country:US
Practice Address - Phone:228-868-0111
Practice Address - Fax:228-863-0802
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-19
Last Update Date:2011-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSD1030133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered