Provider Demographics
NPI:1811394562
Name:BAIR, ANDREA (RD)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:BAIR
Suffix:
Gender:
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 WATTS AVE
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23665-1822
Mailing Address - Country:US
Mailing Address - Phone:715-577-2030
Mailing Address - Fax:
Practice Address - Street 1:3085 E FLAMINGO RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-4308
Practice Address - Country:US
Practice Address - Phone:702-436-0835
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-24
Last Update Date:2025-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered