Provider Demographics
NPI:1952645590
Name:KENNEY, ANDREW JARRETT (RD, LDN)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:JARRETT
Last Name:KENNEY
Suffix:
Gender:M
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 1:111 MURPHREE AVE
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37033-1418
Mailing Address - Country:US
Mailing Address - Phone:931-729-3516
Mailing Address - Fax:931-729-5029
Practice Address - Street 1:111 MURPHREE AVE
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:TN
Practice Address - Zip Code:37033-1418
Practice Address - Country:US
Practice Address - Phone:931-729-3516
Practice Address - Fax:931-729-5029
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-20
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133N00000X
TN2535133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133N00000XDietary & Nutritional Service ProvidersNutritionist