Provider Demographics
NPI:1396999207
Name:HAND, SANDRA LOIS (RD, LDN, CNSD)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:LOIS
Last Name:HAND
Suffix:
Gender:F
Credentials:RD, LDN, CNSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8182 5TH STREET
Mailing Address - Street 2:
Mailing Address - City:LAUREL HILL
Mailing Address - State:FL
Mailing Address - Zip Code:32567
Mailing Address - Country:US
Mailing Address - Phone:850-652-2068
Mailing Address - Fax:850-652-2068
Practice Address - Street 1:8182 5TH ST
Practice Address - Street 2:
Practice Address - City:LAUREL HILL
Practice Address - State:FL
Practice Address - Zip Code:32567-2141
Practice Address - Country:US
Practice Address - Phone:850-652-2068
Practice Address - Fax:850-652-2068
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-06
Last Update Date:2008-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND598133VN1006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic
Provider Identifiers
StateIdentifier IDID TypeIssuer
E7625ZMedicare PIN