Provider Demographics
NPI:1598774408
Name:BURLINGHAM, ANDREA (RD)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:
Last Name:BURLINGHAM
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 1:5500 ARMSTRONG RD
Mailing Address - Street 2:BUILDING 5, ROOM 101A
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49015-1014
Mailing Address - Country:US
Mailing Address - Phone:269-966-5600
Mailing Address - Fax:269-223-5054
Practice Address - Street 1:5500 ARMSTRONG RD
Practice Address - Street 2:BUILDING 5, ROOM 101A
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015-1014
Practice Address - Country:US
Practice Address - Phone:269-966-5600
Practice Address - Fax:269-223-5054
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered