Provider Demographics
NPI:1639675952
Name:OLBRICH, CHANDRA (RDN)
Entity Type:Individual
Prefix:
First Name:CHANDRA
Middle Name:
Last Name:OLBRICH
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7820 N 152ND AVE
Mailing Address - Street 2:
Mailing Address - City:BENNINGTON
Mailing Address - State:NE
Mailing Address - Zip Code:68007-1515
Mailing Address - Country:US
Mailing Address - Phone:402-212-5104
Mailing Address - Fax:
Practice Address - Street 1:7820 N 152ND AVE
Practice Address - Street 2:
Practice Address - City:BENNINGTON
Practice Address - State:NE
Practice Address - Zip Code:68007-1515
Practice Address - Country:US
Practice Address - Phone:402-212-5104
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-04
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered