Provider Demographics
NPI:1821709932
Name:GAEMMERLER, SANDRA CARINA (RD/LDN)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:CARINA
Last Name:GAEMMERLER
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 1:2420 HAVERSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27613-3666
Mailing Address - Country:US
Mailing Address - Phone:941-416-0304
Mailing Address - Fax:
Practice Address - Street 1:2420 HAVERSHIRE DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27613-3666
Practice Address - Country:US
Practice Address - Phone:941-416-0304
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-09
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND9371133V00000X
NCL006949133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered